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Simple Pneumonia and Pleurisy with Complications

Virginia rates for MS-DRG 194

Simple Pneumonia and Pleurisy with CC

Rates data updated July 2026.

How much does Simple Pneumonia and Pleurisy with Complications cost?

$14,791

Typical facility fee. In Virginia, July 2026.

Insurers have agreed to pay about $14,791 for this service. Most negotiated rates run $12,589 to $17,378.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $14,791 · 10th to 90th $10,000 to $19,953
$10K$20Kfacility $14,791

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
$11,220.18
Median
$13,803.84
Typical High
$16,218.10
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$15,135.61
Typical High
$20,417.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$9,120.11
Median
$14,125.38
Typical High
$19,498.45
Sentara
Setting
Facility
Modifier
Global
Typical Low
$11,220.18
Median
$14,791.08
Typical High
$19,952.62
United
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$11,220.18
Typical High
$21,877.62

Where Virginia sits

The same service costs 7.6 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.

Virginia· 21st of 51

$14,791

MT $48,978NM $6,457

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.