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Simple pneumonia & pleurisy w CC

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

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Hospitals
15
Min
$5,972.54
Median
$7,149.32
Max
$11,024
Range multiplier
1.8×

By payer (27 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Anthem BCBS1339$5,473.76$10,741$11,3072.1×
UnitedHealthcare1120$4,697.78$6,960.35$10,9672.3×
Aetna919$5,181.64$6,612.33$8,452.001.6×
WellCare917$4,707.43$6,960.35$9,854.692.1×
Humana816$5,473.76$6,933.80$7,149.321.3×
optum ccn region 277$6,960.35$6,960.35$7,149.321.0×
Molina77$5,583.23$5,583.23$7,099.561.3×
optum ccn region 177$6,960.35$6,960.35$7,149.321.0×
caresoure kentucky55$11,693$11,693$12,0111.0×
Blue Cross Blue Shield14$6,005.68$8,637.88$9,645.661.6×
umr22$10,967$10,967$10,9671.0×
amerihealth12$5,158.62$6,773.85$8,389.081.6×
the health plan12$5,747.44$6,353.90$6,960.351.2×
trillium11$8,640.76$8,640.76$8,640.761.0×
alliance coal11$8,958.81$8,958.81$8,958.811.0×
va community care network11$5,972.54$5,972.54$5,972.541.0×
vaya11$8,472.98$8,472.98$8,472.981.0×
amerigroup11$5,972.54$5,972.54$5,972.541.0×
alliance11$8,556.86$8,556.86$8,556.861.0×
Ambetter11$5,906.46$5,906.46$5,906.461.0×
beacon health11$5,454.36$5,454.36$5,454.361.0×
CareSource11$8,062.93$8,062.93$8,062.931.0×
carolina complete11$8,389.08$8,389.08$8,389.081.0×
christian county health dept-cchd11$5,454.36$5,454.36$5,454.361.0×
Cigna11$5,972.54$5,972.54$5,972.541.0×
healthy blue11$8,389.08$8,389.08$8,389.081.0×
partners11$8,389.08$8,389.08$8,389.081.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Baptist Health LexingtonLexingtonKY12$4,697.78$8,389.08$9,645.66
Hazard ArhHazardKY9$6,561.90$7,149.32$12,011
Middlesboro ArhMiddlesboroKY9$5,200.07$6,960.35$11,693
Harlan ArhHarlanKY9$5,200.07$6,960.35$11,693
Whitesburg ArhWhitesburgKY9$4,707.43$6,960.35$11,693
Highlands Regional Medical CenterPrestonsburgKY8$5,200.07$6,960.35$10,113
Tug Valley ArhSouth WilliamsonKY10$5,200.07$6,960.35$11,693
Paintsville Arh HospitalPaintsvilleKY8$6,264.31$6,960.35$11,307
Jennie Stuart Medical CenterHopkinsvilleKY12$5,181.64$5,972.54$9,854.69
Mary Breckinridge HospitalHydenKY1$10,741$11,024$11,307
Our Lady Of The WayMartinKY1$10,741$11,024$11,307
Barbourville Arh HospitalBarbourvilleKY1$10,741$11,024$11,307
Morgan Co. ArhWest LibertyKY3$10,741$10,967$11,307
Mcdowell ArhMcdowellKY3$10,741$10,967$11,307
Spring View HospitalLebanonKY0$36,214$14,485

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.