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Simple Pneumonia and Pleurisy with Major Complications

New York 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?

$31,623

Typical facility fee. In New York, July 2026.

Insurers have agreed to pay about $31,623 for this service. Most negotiated rates run $19,498 to $41,687.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $31,623 · 10th to 90th $12,589 to $51,286
$10K$20K$50Kfacility $31,623

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
$10,964.78
Median
$26,915.35
Typical High
$45,708.82
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$27,542.29
Median
$43,651.58
Typical High
$53,703.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15,488.17
Median
$31,622.78
Typical High
$44,668.36
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$32,359.37
Typical High
$67,608.30
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$11,481.54
Median
$12,589.25
Typical High
$13,803.84
United
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$22,387.21
Typical High
$41,686.94

Where New York 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 York· 6th of 51

$31,623

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.