Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
MS-DRG 43.00: SIMPLE PNEUMONIA AND PLEURISY WITH MCC
Lehighton, PA
See all hospitals reporting MS-DRG 193 →Price type
St Luke's Hospital - Lehighton Campus’s median price of $12.6k is about the same as the median hospital's median price ($12.7k), higher than 50% of the 2,334 hospitals reporting MS-DRG 193. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 12 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Highmark chip facility · case rate · inpatient | $8.0k | $8.0k | — | — | — | $8.0k – $8.0k |
| 2 | Highmark medicare advantage facility · fee schedule · inpatient | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 3 | Highmark freedom blue medicare advantage facility · fee schedule · inpatient | $12.0k | $12.0k | — | — | — | $12.0k – $12.0k |
| 4 | Aetna medicare facility · fee schedule · inpatient | $12.1k | $12.1k | — | — | — | $12.1k – $12.1k |
| 5 | Humana medicare facility · fee schedule · inpatient | $12.4k | $12.4k | — | — | — | $12.4k – $12.4k |
| 6 | UnitedHealthcare medicare advantage facility · fee schedule · inpatient | $12.8k | $12.8k | — | — | — | $12.8k – $12.8k |
| 7 | Highmark commercial/special care facility · case rate · inpatient | $16.6k | $16.6k | — | — | — | $16.6k – $16.6k |
| 8 | Blue Cross Blue Shield amerihealth facility · case rate · inpatient | $18.4k | $18.4k | — | — | — | $18.4k – $18.4k |
| 9 | Cigna commercial facility · case rate · inpatient | $19.9k | $19.9k | — | — | — | $19.9k – $19.9k |
| 10 | Aetna commercial facility · case rate · inpatient | $21.7k | $21.7k | — | — | — | $21.7k – $21.7k |
| 11 | Aetna medical rental facility · case rate · inpatient | $21.7k | $21.7k | — | — | — | $21.7k – $21.7k |
| 12 | Blue Cross Blue Shield commercial facility · case rate · inpatient | $30.9k | $30.9k | — | — | — | $30.9k – $30.9k |
Last updated: Feb 27, 2026
See Simple pneumonia or pleurisy hospital stay with a major complication or comorbidity pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.