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Simple Pneumonia and Pleurisy with Major Complications

Vermont 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?

$18,621

Typical facility fee. In Vermont, July 2026.

Insurers have agreed to pay about $18,621 for this service. Most negotiated rates run $16,982 to $36,308.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $18,621 · 10th to 90th $15,136 to $37,154
$20K$50Kfacility $18,621

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
BCBS
Setting
Facility
Modifier
Global
Typical Low
$16,982.44
Median
$33,884.42
Typical High
$37,153.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$15,848.93
Median
$18,620.87
Typical High
$36,307.81
United
Setting
Facility
Modifier
Global
Typical Low
$15,135.61
Median
$15,135.61
Typical High
$46,773.51

Where Vermont 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.

Vermont· 30th of 51

$18,621

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.