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Simple Pneumonia and Pleurisy with Major Complications

Pennsylvania 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?

$19,498

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $19,498 for this service. Most negotiated rates run $13,183 to $25,119.

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 $19,498 · 10th to 90th $10,965 to $30,903
$5K$10K$20Kfacility $19,498

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
$12,022.64
Median
$21,877.62
Typical High
$30,902.95
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$18,197.01
Median
$26,915.35
Typical High
$40,738.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$11,481.54
Median
$21,379.62
Typical High
$29,512.09
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$23,442.29
Median
$23,442.29
Typical High
$28,183.83
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$22,387.21
Typical High
$27,542.29
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$19,952.62
Typical High
$27,542.29
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$19,952.62
Typical High
$30,902.95
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$10,232.93
Median
$12,589.25
Typical High
$20,892.96
United
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$16,982.44
Typical High
$30,902.95

Where Pennsylvania 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.

Pennsylvania· 29th of 51

$19,498

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.