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Simple pneumonia & pleurisy w CC

MS-DRG 194 · negotiated-rate distribution across hospitals in GA

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Hospitals
15
Min
$6,155.87
Median
$11,409
Max
$18,106
Range multiplier
2.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
healthpartners347$7,905.62$18,106$25,6013.2×
Blue Cross Blue Shield1142$25$12,024$24,768990.7×
Aetna1131$90$13,337$20,160224.0×
UnitedHealthcare1027$5,104.89$11,677$35,8117.0×
Cigna1127$85$11,689$23,445275.8×
Humana1120$3,210.42$13,714$21,2496.6×
WellCare78$5,054.35$8,287.16$12,0392.4×
Oscar Health77$8,086.96$11,375$15,1801.9×
devoted health66$5,847.62$10,166$12,0272.1×
Ambetter55$8,339.68$20,221$22,8842.7×
Kaiser Permanente44$5,847.62$10,166$10,7941.8×
optum44$5,847.62$10,166$10,7941.8×
clover health44$6,140$10,675$11,3341.8×
sonder health plans44$6,140$10,675$11,3341.8×
va community care network44$5,847.62$10,166$10,7941.8×
First Health23$95$6,155.87$7,30076.8×
TRICARE23$5,193.32$5,193.32$6,342.811.2×
CareSource13$12,039$12,039$20,4341.7×
sonder health plan12$12,273$12,273$12,2731.0×
peach state12$7,898.24$9,968.7$12,0391.5×
riverwood behavioral health12$11,677$11,683$11,6891.0×
Health Net12$97$3,126.44$6,155.8763.5×
occunet11$11,372$11,372$11,3721.0×
pcc employee11$10,815$10,815$10,8151.0×
prime health services11$7,739.54$7,739.54$7,739.541.0×
provider select11$7,899.12$7,899.12$7,899.121.0×
rural arizona network11$6,155.87$6,155.87$6,155.871.0×
smarthealth11$7,076.09$7,076.09$7,076.091.0×
ubh optum11$11,689$11,689$11,6891.0×
united mine workers of america11$6,155.87$6,155.87$6,155.871.0×
three rivers11$7,739.54$7,739.54$7,739.541.0×
americas choice provider network11$7,739.54$7,739.54$7,739.541.0×
arizona medical network11$6,155.87$6,155.87$6,155.871.0×
banner health11$6,155.87$6,155.87$6,155.871.0×
blue mcr replacement11$5,054.35$5,054.35$5,054.351.0×
bridgeway health solutions11$6,155.87$6,155.87$6,155.871.0×
centurion11$17,515$17,515$17,5151.0×
clear spring health plan11$11,677$11,677$11,6771.0×
corvel11$7,579.96$7,579.96$7,579.961.0×
employer direct healthcare11$15,180$15,180$15,1801.0×
facility billing - op11$5,054.35$5,054.35$5,054.351.0×
georgia workers’ compensation11$7,978.91$7,978.91$7,978.911.0×
health choice pathway11$6,155.87$6,155.87$6,155.871.0×
health management network11$6,155.87$6,155.87$6,155.871.0×
healthspring mcr replacement11$5,155.44$5,155.44$5,155.441.0×
imperial insurance11$6,463.67$6,463.67$6,463.671.0×
Medicare11$11,677$11,677$11,6771.0×
Medicare Advantage11$5,054.35$5,054.35$5,054.351.0×
Multiplan11$7,739.54$7,739.54$7,739.541.0×
naphcare11$18,099$18,099$18,0991.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
ST. JOSEPHS OF ATLANTAATLANTAGA14$5,847.62$9,916.02$17,409
ST. MARYS SACRED HEART HOSPITALLAVONIAGA17$5,054.35$8,339.68$19,155
WEST CENTRAL GA REGIONAL HOSPITALCOLUMBUSGA17$25$6,155.87$35,811
NORTHEAST GEORGIA MEDICAL CENTERGAINESVILLEGA6$7,905.62$18,106$25,601
EMORY LONG TERM ACUTE CAREDECATURGA5$11,375$15,854$16,375
NGMC LUMPKIN LLCDAHLONEGAGA6$7,905.62$15,652$25,601
NGMC BARROWWINDERGA6$7,905.62$15,652$24,768
SOUTHERN REGIONAL MEDICAL CENTERRIVERDALEGA28$11,676$3,210.42$11,677$20,434
EMORY UNIVERSITY HOSPITALATLANTAGA14$8,457$11,409$22,884
EMORY UNIVERSITY HOSPITAL MIDTOWNATLANTAGA14$8,457$11,409$22,884
EMORY DECATURDECATURGA14$8,457$10,743$20,221
MEMORIAL HOSPITALBAINBRIDGEGA0
SOUTHWELL MEDICALADELGA0
CHATUGE REGIONAL HOSPITALHIWASSEEGA0
UNION GENERAL HOSPITALBLAIRSVILLEGA0

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.