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Simple pneumonia & pleurisy w CC

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

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Hospitals
4
Min
$6,010.23
Median
$7,177.21
Max
$16,138
Range multiplier
2.7×

By payer (24 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare410$6,010.23$9,743.81$19,5993.3×
Humana46$6,010.23$7,028.72$26,9254.5×
Aetna26$6,837.22$9,839.58$15,8992.3×
Anthem BCBS25$6,929.28$14,562$21,7923.1×
workers compensation33$8,962.96$9,500.74$9,500.741.1×
Medicare33$6,010.23$6,276.87$7,177.211.2×
sentara health plan12$7,637.32$11,241$14,8451.9×
Cigna12$16,138$16,689$17,2391.1×
connecticare11$16,761$16,761$16,7611.0×
martins point11$13,685$13,685$13,6851.0×
Medicaid11$5,675.49$5,675.49$5,675.491.0×
Multiplan11$19,554$19,554$19,5541.0×
Self-Pay (Cash)11$7,177.21$7,177.21$7,177.211.0×
TRICARE11$13,685$13,685$13,6851.0×
community health options11$17,142$17,142$17,1421.0×
vhn11$19,155$19,155$19,1551.0×
vhn - link11$21,549$21,549$21,5491.0×
vhn - plus11$18,437$18,437$18,4371.0×
vhn - secondary payors11$22,746$22,746$22,7461.0×
vhn - ultra11$14,845$14,845$14,8451.0×
WellCare11$6,929.28$6,929.28$6,929.281.0×
gateway - tier 211$19,155$19,155$19,1551.0×
gateway - tier 111$22,746$22,746$22,7461.0×
gateway - tier 311$16,282$16,282$16,2821.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Central Maine Medical CenterLewistonME13$7,177.00$5,675.49$7,177.21$19,599
Rumford HospitalRumfordME4$6,276.00$6,276.87$6,276.87$9,500.74
Bridgton HospitalBridgtonME4$6,010.00$6,010.23$6,010.23$9,500.74
Franklin Memorial HospitalFarmingtonME15$23,944$8,380.28$6,837.22$16,138$26,925

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.