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Inborn and Other Disorders of Metabolism

Pennsylvania 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?

$20,893

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $20,893 for this service. Most negotiated rates run $14,791 to $26,303.

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 $20,893 · 10th to 90th $12,023 to $29,512
$5K$10K$20Kfacility $20,893

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
$12,882.50
Median
$21,379.62
Typical High
$29,512.09
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$13,182.57
Median
$22,908.68
Typical High
$34,673.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$22,908.68
Typical High
$31,622.78
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$25,118.86
Median
$25,118.86
Typical High
$30,199.52
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$23,988.33
Typical High
$29,512.09
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$10,232.93
Median
$25,118.86
Typical High
$39,810.72
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$12,882.50
Median
$20,892.96
Typical High
$30,199.52
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$11,220.18
Median
$14,125.38
Typical High
$22,908.68
United
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$18,197.01
Typical High
$33,113.11

Where Pennsylvania 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.

Pennsylvania· 28th of 51

$20,893

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.