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Pennsylvania 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?

$26,915

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $26,915 for this service. Most negotiated rates run $19,055 to $33,884.

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 9 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $26,915 · 10th to 90th $15,136 to $41,687
$2.0K$5.0K$10.0K$20.0K$50.0K$100.0Kfacility $26,915

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
$16,218.10
Median
$28,840.32
Typical High
$41,686.94
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$20,892.96
Median
$36,307.81
Typical High
$54,954.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$14,791.08
Median
$27,542.29
Typical High
$38,904.51
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$30,902.95
Median
$30,902.95
Typical High
$38,018.94
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$12,882.50
Median
$29,512.09
Typical High
$36,307.81
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$17,378.01
Median
$31,622.78
Typical High
$64,565.42
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$15,848.93
Median
$26,302.68
Typical High
$41,686.94
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$13,803.84
Median
$16,982.44
Typical High
$27,542.29
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$22,908.68
Typical High
$41,686.94

Where Pennsylvania sits

The same service costs 3.4 times more in Montana than in New Mexico. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $26,915 · 30th of 51
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.