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Simple Pneumonia and Pleurisy with Major Complications

California rates for MS-DRG 193

Simple Pneumonia and Pleurisy with MCC

Rates data updated July 2026.

How much does Simple Pneumonia and Pleurisy with Major Complications cost?

$33,113

Typical facility fee. In California, July 2026.

Insurers have agreed to pay about $33,113 for this service. Most negotiated rates run $25,119 to $47,863.

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 $33,113 · 10th to 90th $17,783 to $54,954
$200$1K$5K$20Kfacility $33,113

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
$20,417.38
Median
$30,199.52
Typical High
$56,234.13
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$18,620.87
Median
$33,113.11
Typical High
$54,954.09
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$14,791.08
Median
$23,988.33
Typical High
$66,069.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$18,197.01
Median
$26,915.35
Typical High
$46,773.51
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
$46,773.51
Median
$46,773.51
Typical High
$46,773.51
Providence
Setting
Facility
Modifier
Global
Typical Low
$18,620.87
Median
$26,915.35
Typical High
$54,954.09
United
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$22,908.68
Typical High
$51,286.14

Where California sits

The same service costs 6.9 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· 2nd of 51

$33,113

MT $72,444NM $10,471

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.