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Simple Pneumonia and Pleurisy without Complications

Missouri rates for MS-DRG 195

Simple Pneumonia and Pleurisy without CC/MCC

Rates data updated July 2026.

How much does Simple Pneumonia and Pleurisy without Complications cost?

$7,413

Typical facility fee. In Missouri, July 2026.

Insurers have agreed to pay about $7,413 for this service. Most negotiated rates run $6,166 to $11,220.

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 $7,413 · 10th to 90th $4,786 to $14,791
$1K$2K$5K$10Kfacility $7,413

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
$6,456.54
Median
$8,912.51
Typical High
$19,054.61
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$7,244.36
Typical High
$12,022.64
BCBS
Setting
Facility
Modifier
Global
Typical Low
$151,356.12
Median
$151,356.12
Typical High
$151,356.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$6,309.57
Median
$8,317.64
Typical High
$13,489.63
Medica
Setting
Facility
Modifier
Global
Typical Low
$5,248.07
Median
$8,317.64
Typical High
$19,498.45
United
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$7,413.10
Typical High
$10,471.29

Where Missouri sits

The same service costs 9.5 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.

Missouri· 39th of 51

$7,413

MT $48,978NM $5,129

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.