go back

Simple Pneumonia and Pleurisy without Complications

Ohio rates for MS-DRG 195

Simple Pneumonia and Pleurisy without CC/MCC

Rates data updated October 2026.

How much does Simple Pneumonia and Pleurisy without Complications cost?

$9,550

Typical facility fee. In Ohio, October 2026.

Insurers have agreed to pay about $9,550 for this service. Most negotiated rates run $7,586 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 $9,550 · 10th to 90th $6,026 to $13,183
$5K$10Kfacility $9,550

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$6,025.60
Median
$8,912.51
Typical High
$12,882.50
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$6,165.95
Median
$8,709.64
Typical High
$13,489.63
Cigna
Setting
Facility
Modifier
None
Typical Low
$6,165.95
Median
$10,000.00
Typical High
$13,182.57
Medical Mutual of Ohio
Setting
Facility
Modifier
None
Typical Low
$6,165.95
Median
$10,715.19
Typical High
$13,182.57
SummaCare
Setting
Facility
Modifier
None
Typical Low
$3,630.78
Median
$5,623.41
Typical High
$7,762.47
United
Setting
Facility
Modifier
None
Typical Low
$5,623.41
Median
$10,715.19
Typical High
$14,125.38

Where Ohio sits

The same service costs 74.1 times more in Michigan than in Hawaii. 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.

Ohio· 30th of 51

$9,550

MI $20,417HI $275

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.