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Simple Pneumonia and Pleurisy with Major Complications

Texas 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?

$16,982

Typical facility fee. In Texas, July 2026.

Insurers have agreed to pay about $16,982 for this service. Most negotiated rates run $12,023 to $22,387.

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 $16,982 · 10th to 90th $8,318 to $30,903
$5K$10K$20K$50Kfacility $16,982

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
$12,589.25
Median
$19,054.61
Typical High
$36,307.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,918.31
Median
$13,489.63
Typical High
$22,908.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$19,952.62
Typical High
$35,481.34
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
$11,748.98
Median
$16,982.44
Typical High
$39,810.72
United
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$13,803.84
Typical High
$32,359.37

Where Texas 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.

Texas· 34th of 51

$16,982

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.