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Inborn and Other Disorders of Metabolism

California rates for MS-DRG 642

Inborn and Other Disorders of Metabolism

Rates data updated July 2026.

How much does Inborn and Other Disorders of Metabolism cost?

$35,481

Typical facility fee. In California, July 2026.

Insurers have agreed to pay about $35,481 for this service. Most negotiated rates run $26,915 to $51,286.

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 $35,481 · 10th to 90th $18,197 to $60,256
$200$1K$5K$20Kfacility $35,481

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
$21,877.62
Median
$33,113.11
Typical High
$60,255.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$35,481.34
Typical High
$60,255.96
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$8,912.51
Median
$19,952.62
Typical High
$46,773.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$17,378.01
Median
$27,542.29
Typical High
$50,118.72
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
$51,286.14
Median
$51,286.14
Typical High
$51,286.14
Providence
Setting
Facility
Modifier
Global
Typical Low
$19,952.62
Median
$28,840.32
Typical High
$57,543.99
United
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$25,118.86
Typical High
$54,954.09

Where California sits

The same service costs 4.4 times more in Montana than in Mississippi. 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· 2nd of 51

$35,481

MT $48,978MS $11,220

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.