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Simple pneumonia & pleurisy w CC

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

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Hospitals
22
Min
$7,708
Median
$12,972
Max
$18,958
Range multiplier
2.5×

By payer (48 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield2195$85$12,199$28,735338.1×
Aetna2179$6,462.74$20,015$49,4357.6×
UnitedHealthcare2173$6,663.3$17,548$37,8795.7×
horizon971$5,336$19,172$51,7359.7×
Cigna2147$7,963.36$19,391$37,0624.7×
amerihealth2037$6,327.27$14,921$27,3324.3×
WellCare2029$6,462.74$9,428.23$16,9942.6×
qualcare inc815$5,565$6,765$17,9593.2×
Humana1212$6,532.65$7,826.6$10,5611.6×
wellpoint812$1,885$6,665.32$8,539.624.5×
clover health1111$6,532.65$7,693.59$10,3601.6×
amerigroup910$6,462.74$7,561.62$11,7481.8×
clover99$7,109.01$8,219.79$12,9231.8×
oxford99$25,992$26,601$35,0071.3×
brighton health plan99$30,610$30,610$37,8631.2×
seoul medical group99$7,238.27$8,369.24$13,1581.8×
vaccn99$5,946.04$6,768.04$9,867.081.7×
karna99$10,293$11,639$17,3401.7×
First Health88$60$60$601.0×
Emblem Health88$9,987$12,642$16,1521.6×
fidelis care88$6,532.65$7,434.06$8,539.621.3×
qualcare26$23,668$31,834$31,8341.3×
Medicare46$7,469.5$7,733.65$10,0581.3×
optum health36$6,120.55$7,596.64$9,428.231.5×
Ambetter44$9,776.78$15,312$20,6192.1×
jefferson health plan33$7,992.37$7,992.37$10,7621.3×
wellpoint full dual advantage33$7,469.5$7,469.5$10,0581.3×
oxford health plans33$20,219$20,219$20,2191.0×
braven health33$7,469.5$7,469.5$10,0581.3×
horizon nj total care33$7,469.5$7,469.5$10,0581.3×
healthspring33$7,693.59$7,693.59$10,3601.3×
horizon nj health33$5,060$5,060$5,0601.0×
ubh22$6,476.74$7,063.72$7,650.691.2×
geisinger health plan12$8,582.54$19,605$30,6283.6×
jeff nj amerihealth_ibc12$11,897$13,039$14,1801.2×
point of comfort refugee resettlement11$7,657.08$7,657.08$7,657.081.0×
provider partners health plan11$8,193.07$8,193.07$8,193.071.0×
optum va ccn11$7,657.08$7,657.08$7,657.081.0×
naphcare11$12,251$12,251$12,2511.0×
Medicare Advantage11$7,891.06$7,891.06$7,891.061.0×
st agnes11$7,657.08$7,657.08$7,657.081.0×
inspira life11$7,657.08$7,657.08$7,657.081.0×
innovage11$7,810.22$7,810.22$7,810.221.0×
va_champus_tricare11$7,657.08$7,657.08$7,657.081.0×
ibc main line health11$9,571.35$9,571.35$9,571.351.0×
ibc employee benefit11$9,571.35$9,571.35$9,571.351.0×
devoted health participation11$8,039.93$8,039.93$8,039.931.0×
allwell pa health_wellness ma11$8,422.78$8,422.78$8,422.781.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
HMH -OCEAN MEDICAL CENTERBRICKNJ14$6,768.04$6,552.97$9,963$31,407
JERSEY SHORE UNIVERSITY MED CTRNEPTUNENJ16$6,956.45$6,120.55$8,874.8$51,735
KENNEDY UNIVERSITY HOSPITALCHERRY HILLNJ22$8,756.71$7,657.08$8,422.78$30,628
INSPIRA MEDICAL CENTER ELMERELMERNJ17$5,060$7,992.37$28,735
INSPIRA MEDICAL CENTER WOODBURY INCWOODBURYNJ17$5,060$7,917.68$28,735
RIVERVIEW MEDICAL CENTERRED BANKNJ15$6,956.45$5,992.17$7,772.09$30,998
SOUTHERN OCEAN MEDICAL CENTERMANAHAWKINNJ14$5,946.04$5,778$7,731.65$31,244
BAYSHORE MEDICAL CENTERHOLMDELNJ14$6,956.45$5,778$7,708$38,130
RARITAN BAY MEDICAL CENTERPERTH AMBOYNJ14$6,956.45$5,778$7,708$38,130
HACKENSACK UNIVERSITY MEDICAL CENTERHACKENSACKNJ16$6,658$18,958$49,435
JFK UNIVERSITY MEDICAL CENTEREDISONNJ16$6,658$18,958$49,435
NEWARK BETH ISRAEL MEDICAL CENTERNEWARKNJ13$3,470$60$15,261$26,608
COOPERMAN BARNABAS MEDICAL CENTERLIVINGSTONNJ13$3,319$60$15,081$24,031
JERSEY CITY MEDICAL CENTERJERSEY CITYNJ13$5,589$60$14,976$24,739
ROBERT WOOD JOHNSON UNIV HOSP @ SOMSOMERVILLENJ13$2,486$60$14,921$29,202
MONMOUTH MEDICAL CENTERLONG BRANCENJ13$3,629$60$13,390$21,885
COMMUNITY MEDICAL CENTERTOMS RIVERNJ13$2,426$60$13,310$23,985
PALISADES MEDICAL CENTERNORTH BERGENNJ14$9,867.08$5,336$13,040$33,278
ROBERT WOOD JOHNSON UNIVERSITY HOSPINEW BRUNSWICKNJ13$3,233$60$12,972$20,851
ROBERT WOOD JOHNSON HOSPITAL @ HAMIHAMILTONNJ13$3,233$60$12,972$20,851
INSPIRA MEDICAL CENTER VINELANDVINELANDNJ17$5,060$10,762$28,735
WEST JERSEY HEALTH SYSTEMVOORHEESNJ0

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.