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Simple Pneumonia and Pleurisy with Major Complications

Washington 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?

$29,512

Typical facility fee. In Washington, July 2026.

Insurers have agreed to pay about $29,512 for this service. Most negotiated rates run $23,442 to $35,481.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $29,512 · 10th to 90th $17,783 to $43,652
$10K$20K$50Kfacility $29,512

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
$21,877.62
Median
$33,884.42
Typical High
$54,954.09
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$15,848.93
Median
$26,915.35
Typical High
$38,904.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$19,054.61
Median
$28,183.83
Typical High
$42,657.95
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$15,135.61
Median
$22,908.68
Typical High
$28,840.32
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$17,378.01
Median
$25,118.86
Typical High
$38,018.94
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$19,054.61
Median
$26,915.35
Typical High
$37,153.52
United
Setting
Facility
Modifier
Global
Typical Low
$11,481.54
Median
$26,302.68
Typical High
$38,018.94

Where Washington 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.

Washington· 9th of 51

$29,512

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.