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California rates for MS-DRG 542

Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with MCC

Rates data updated July 2026.

How much does MS-DRG 542 cost?

$43,652

Typical facility fee. In California, July 2026.

Insurers have agreed to pay about $43,652 for this service. Most negotiated rates run $33,884 to $64,565.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $43,652 · 10th to 90th $24,547 to $74,131
$200$1K$5K$20K$100Kfacility $43,652

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$26,915.35
Median
$40,738.03
Typical High
$75,857.76
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$25,118.86
Median
$43,651.58
Typical High
$74,131.02
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$33,113.11
Typical High
$64,565.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$25,118.86
Median
$36,307.81
Typical High
$63,095.73
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$194.98
Typical High
$302.00
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$63,095.73
Median
$63,095.73
Typical High
$63,095.73
Providence
Setting
Facility
Modifier
Global
Typical Low
$25,118.86
Median
$40,738.03
Typical High
$74,131.02
United
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$31,622.78
Typical High
$69,183.10

Where California sits

The same service costs 3.4 times more in Montana than in New Mexico. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

California· 4th of 51

$43,652

MT $47,863NM $14,125

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.