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Simple pneumonia & pleurisy w/o CC/MCC

MS-DRG 195 · negotiated-rate distribution across hospitals in GA

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Hospitals
15
Min
$4,674.71
Median
$9,897.45
Max
$13,751
Range multiplier
2.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
healthpartners347$6,004.41$13,751$19,4443.2×
Blue Cross Blue Shield1142$21.00$10,326$19,155912.1×
Aetna1131$90.00$10,130$16,275180.8×
UnitedHealthcare1027$3,981.18$10,405$27,4896.9×
Cigna1127$85.00$10,414$17,807209.5×
Humana1120$3,160.32$10,416$16,1395.1×
WellCare78$3,941.76$6,807.00$10,7262.7×
Oscar Health77$6,306.82$8,639.48$13,5262.1×
devoted health66$4,560.40$8,797.12$10,7172.3×
Ambetter55$6,503.90$17,411$19,8893.1×
Kaiser Permanente44$4,560.40$8,797.12$9,381.472.1×
optum44$4,560.40$8,797.12$9,381.472.1×
clover health44$4,788.42$9,236.98$9,850.542.1×
sonder health plans44$4,788.42$9,236.98$9,850.542.1×
va community care network44$4,560.40$8,797.12$9,381.472.1×
First Health23$95.00$4,674.71$7,300.0076.8×
TRICARE23$3,761.78$3,761.78$5,052.561.3×
CareSource13$10,726$10,726$18,2081.7×
sonder health plan12$10,935$10,935$10,9351.0×
peach state12$5,997.85$8,362.14$10,7261.8×
riverwood behavioral health12$10,405$10,409$10,4141.0×
Health Net12$97.00$2,385.86$4,674.7148.2×
occunet11$8,868.96$8,868.96$8,868.961.0×
pcc employee11$10,815$10,815$10,8151.0×
prime health services11$5,888.90$5,888.90$5,888.901.0×
provider select11$6,010.32$6,010.32$6,010.321.0×
rural arizona network11$4,674.71$4,674.71$4,674.711.0×
smarthealth11$5,518.46$5,518.46$5,518.461.0×
ubh optum11$10,414$10,414$10,4141.0×
united mine workers of america11$4,674.71$4,674.71$4,674.711.0×
three rivers11$5,888.90$5,888.90$5,888.901.0×
americas choice provider network11$5,888.90$5,888.90$5,888.901.0×
arizona medical network11$4,674.71$4,674.71$4,674.711.0×
banner health11$4,674.71$4,674.71$4,674.711.0×
blue mcr replacement11$3,941.76$3,941.76$3,941.761.0×
bridgeway health solutions11$4,674.71$4,674.71$4,674.711.0×
centurion11$15,607$15,607$15,6071.0×
clear spring health plan11$10,405$10,405$10,4051.0×
corvel11$5,767.48$5,767.48$5,767.481.0×
employer direct healthcare11$13,526$13,526$13,5261.0×
facility billing - op11$3,941.76$3,941.76$3,941.761.0×
georgia workers’ compensation11$6,071.04$6,071.04$6,071.041.0×
health choice pathway11$4,674.71$4,674.71$4,674.711.0×
health management network11$4,674.71$4,674.71$4,674.711.0×
healthspring mcr replacement11$4,020.60$4,020.60$4,020.601.0×
imperial insurance11$4,908.45$4,908.45$4,908.451.0×
Medicare11$10,405$10,405$10,4051.0×
Medicare Advantage11$3,941.76$3,941.76$3,941.761.0×
Multiplan11$5,888.90$5,888.90$5,888.901.0×
naphcare11$16,127$16,127$16,1271.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Emory University HospitalAtlantaGA14$6,423.19$9,897.45$19,889
Emory University Hospital MidtownAtlantaGA14$6,423.19$9,897.45$19,889
Emory DecaturDecaturGA14$6,423.19$8,672.51$17,411
St. Josephs Of AtlantaAtlantaGA14$4,560.40$7,531.34$13,222
St. Marys Sacred Heart HospitalLavoniaGA17$3,761.78$7,300.00$19,155
West Central Ga Regional HospitalColumbusGA17$21.00$4,674.71$27,489
Northeast Georgia Medical CenterGainesvilleGA6$6,004.41$13,751$19,444
Ngmc Lumpkin LlcDahlonegaGA6$6,004.41$12,843$19,444
Ngmc BarrowWinderGA6$6,004.41$12,843$18,811
Emory Long Term Acute CareDecaturGA5$8,639.48$12,041$12,437
Southern Regional Medical CenterRiverdaleGA28$10,404$3,160.32$10,305$18,208
Memorial HospitalBainbridgeGA0
Southwell MedicalAdelGA0
Union General HospitalBlairsvilleGA0
Chatuge Regional HospitalHiwasseeGA0

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.