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Simple pneumonia & pleurisy w CC

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

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Hospitals
18
Min
$5,432.59
Median
$7,190.47
Max
$15,145
Range multiplier
2.8×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield9131$95$15,009$31,434330.9×
UnitedHealthcare977$45$15,145$41,530922.9×
Medicaid556$3,020.93$3,277.71$22,2677.4×
Cigna936$25.2$7,589.44$15,858629.3×
Aetna934$29.1$58.8$7,661.65263.3×
Medicare531$6,130.14$6,130.14$7,772.691.3×
Humana823$90$7,604.36$23,380259.8×
Molina517$3,277.71$6,067.82$12,5833.8×
no fault [114001]114$4,625.43$4,625.43$4,625.431.0×
absolute total care412$2,020$6,706.32$13,7296.8×
WellCare210$5,541.24$5,835.69$6,130.141.1×
select health of sc [4890]410$7,300.16$11,251$23,3803.2×
select health410$6,246.28$7,549.99$38,5486.2×
univera healthcare [100169]19$6,913.89$9,877.42$9,877.421.4×
independent health [100165]17$6,704.81$9,836.33$10,4601.6×
clover insurance company36$6,186.79$6,471.06$7,478.091.2×
devoted health35$5,541.24$5,948.84$6,222.171.1×
univera healthcare essential [100170]15$3,277.71$3,277.71$3,277.711.0×
select health of sc [4877]44$6,982.4$9,968.44$12,9541.9×
devoted health plan [4501]44$6,982.4$7,192.48$7,402.561.1×
Multiplan44$90$90$14,676163.1×
VA Health14$6,130.14$6,130.14$6,573.221.1×
first choice vip care plus [4833]44$7,331.52$7,552.11$7,772.691.1×
umr [3113]44$15,145$15,145$15,1451.0×
pai [3082]44$15,009$15,724$16,4391.1×
phcs33$90$90$901.0×
amedisys hospice13$670$670$6701.0×
amerigroup [350102]13$3,277.71$3,277.71$3,277.711.0×
beacon essential [350122]13$3,020.93$3,020.93$3,051.141.0×
federal workers compensation [500100]13$6,130.14$6,130.14$6,130.141.0×
fidelis essential [100163]13$3,277.71$3,277.71$3,277.711.0×
independent health essential [100166]13$3,277.71$3,933.25$3,933.251.2×
medcost - sc33$50.44$58.51$13,768272.9×
plotkin health33$60$60$601.0×
regency hospice13$5,432.59$5,432.59$5,432.591.0×
TRICARE13$6,573.22$6,573.22$6,573.221.0×
eon health12$995$3,322.45$5,649.895.7×
nhc advantage12$995$3,322.45$5,649.895.7×
agape hospice12$525$525$5251.0×
apex health12$995$3,322.45$5,649.895.7×
prime health12$85$3,769.26$7,453.5187.7×
pruitt health12$995$3,322.45$5,649.895.7×
devoted health plan12$7,190.47$7,190.47$7,190.471.0×
sc state employees12$3,889$5,850$7,8112.0×
fidelis dual advantage [450120]12$6,130.14$6,130.14$6,130.141.0×
iha first choice [800001]12$8,260.81$8,260.81$8,260.811.0×
hospice [550001]12$1,063.88$1,063.88$1,063.881.0×
medcost12$56.9$65.3$73.71.3×
mvp healthcare [100168]11$7,120.4$7,120.4$7,120.41.0×
naphcare11$10,594$10,594$10,5941.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
HILTON HEAD HOSPITALHILTON HEAD ISLANDSC14$8,763$32.2$7,190.47$41,530
COASTAL CAROLINA MEDICAL CENTERHARDEEVILLESC14$9,613.01$25.2$6,222.17$41,412
MARY BLACK MEMORIAL HOSPITALSPARTANBURGSC33$17,979$11,823$1,063.88$6,130.14$15,205
EAST COOPER REGIONAL MEDICAL CENTERMT. PLEASANTSC14$9,437.75$36.9$6,097.57$26,695
COLLETON MEDICAL CENTERWALTERBOROSC43$45$5,432.59$38,548
BON SECOURS ST. FRANCIS XAVIER HOSPICHARLESTONSC13$7,402.56$15,145$23,380
ROPER ST. FRANCIS MT PLEASANT HOSPITMT. PLEASANTSC13$7,402.56$15,145$23,380
ROPER HOSPITAL INC.CHARLESTONSC13$4,650.04$15,009$15,858
ROPER ST. FRANCIS HOSPITAL-BERKELEYSUMMERVILLESC13$4,650.04$15,009$15,858
EDGEFIELD COUNTY HEALTHCAREEDGEFIELDSC0
CONWAY HOSPITALCONWAYSC0
MCLEOD REGIONAL MEDICAL CENTERFLORENCESC0
SELF REGIONAL HEALTHCAREGREENWOODSC0
AIKEN REGIONAL MEDICAL CENTERAIKENSC0
MCLEOD LORIS SEACOAST HOSPITALLORISSC0
MCLEOD HEALTH CHERAWCHERAWSC0
MCLEOD HEALTH CLARENDONMANNINGSC0
MCLEOD MEDICAL CENTER - DILLONDILLONSC0

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.