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Simple Pneumonia and Pleurisy without Complications

Texas 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?

$7,762

Typical facility fee. In Texas, October 2026.

Insurers have agreed to pay about $7,762 for this service. Most negotiated rates run $5,888 to $11,482.

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 $7,762 · 10th to 90th $4,074 to $15,488
$5K$10K$20K$50Kfacility $7,762

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
$5,888.44
Median
$10,964.78
Typical High
$14,791.08
Ambetter
Setting
Facility
Modifier
None
Typical Low
$10,000.00
Median
$12,589.25
Typical High
$17,378.01
BCBS Texas
Setting
Facility
Modifier
None
Typical Low
$3,630.78
Median
$7,413.10
Typical High
$12,589.25
Cigna
Setting
Facility
Modifier
None
Typical Low
$5,623.41
Median
$9,772.37
Typical High
$19,952.62
Moda Health
Setting
Facility
Modifier
None
Typical Low
$5,623.41
Median
$14,791.08
Typical High
$14,791.08
Providence
Setting
Facility
Modifier
None
Typical Low
$5,754.40
Median
$10,715.19
Typical High
$26,915.35
United
Setting
Facility
Modifier
None
Typical Low
$3,311.31
Median
$7,762.47
Typical High
$17,378.01

Where Texas 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.

Texas· 39th of 51

$7,762

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.