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Simple Pneumonia and Pleurisy with Major Complications

Ohio 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?

$18,197

Typical facility fee. In Ohio, July 2026.

Insurers have agreed to pay about $18,197 for this service. Most negotiated rates run $13,804 to $22,909.

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 $18,197 · 10th to 90th $11,482 to $25,704
$10K$20Kfacility $18,197

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
$15,488.17
Median
$20,892.96
Typical High
$25,703.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$10,964.78
Median
$16,218.10
Typical High
$24,547.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$16,595.87
Typical High
$28,183.83
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$17,782.79
Typical High
$28,183.83
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$5,248.07
Median
$10,232.93
Typical High
$25,703.96
United
Setting
Facility
Modifier
Global
Typical Low
$10,232.93
Median
$18,620.87
Typical High
$28,840.32

Where Ohio 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.

Ohio· 32nd of 51

$18,197

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.