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Simple Pneumonia and Pleurisy with Major Complications

New Jersey 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?

$28,840

Typical facility fee. In New Jersey, July 2026.

Insurers have agreed to pay about $28,840 for this service. Most negotiated rates run $22,387 to $35,481.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $28,840 · 10th to 90th $16,596 to $42,658
$10K$20K$50Kfacility $28,840

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
$19,952.62
Median
$31,622.78
Typical High
$42,657.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15,135.61
Median
$32,359.37
Typical High
$41,686.94
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$25,703.96
Typical High
$36,307.81
United
Setting
Facility
Modifier
Global
Typical Low
$6,025.60
Median
$14,454.40
Typical High
$36,307.81

Where New Jersey 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.

New Jersey· 10th of 51

$28,840

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.