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Simple Pneumonia and Pleurisy without Complications

Virginia 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?

$11,220

Typical facility fee. In Virginia, October 2026.

Insurers have agreed to pay about $11,220 for this service. Most negotiated rates run $8,913 to $14,125.

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 $11,220 · 10th to 90th $7,079 to $17,378
$5K$10K$20Kfacility $11,220

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
$7,079.46
Median
$12,022.64
Typical High
$13,182.57
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$7,413.10
Median
$11,220.18
Typical High
$15,135.61
CareFirst
Setting
Facility
Modifier
None
Typical Low
$7,943.28
Median
$10,715.19
Typical High
$13,489.63
Cigna
Setting
Facility
Modifier
None
Typical Low
$6,606.93
Median
$10,964.78
Typical High
$16,218.10
Medcost
Setting
Facility
Modifier
None
Typical Low
$12,022.64
Median
$12,022.64
Typical High
$12,022.64
Sentara
Setting
Facility
Modifier
None
Typical Low
$7,413.10
Median
$11,220.18
Typical High
$18,197.01
United
Setting
Facility
Modifier
None
Typical Low
$3,981.07
Median
$11,748.98
Typical High
$17,378.01

Where Virginia 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.

Virginia· 17th of 51

$11,220

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.