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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
21
Min
$71.25
Median
$5,326.19
Max
$12,498
Range multiplier
175.4×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare1947$71.39$6,840.98$15,228213.3×
Aetna1531$69.22$6,318.54$13,073188.9×
Blue Cross Blue Shield1729$57$4,681.64$14,094247.3×
amerigroup1619$3,586.32$4,863.31$15,5334.3×
Humana1719$71.25$4,819.33$6,904.7196.9×
medica315$91$96$14,722161.8×
medica exchange insure1414$9,737.99$9,737.99$9,737.991.0×
medica exchange inspire1313$8,739.22$8,739.22$8,739.221.0×
Molina1213$69.22$5,093.72$12,023173.7×
iowa total care1212$3,993.34$4,768.43$4,999.951.3×
health partners open network1010$5,604.3$6,039.88$7,251.341.3×
amerivantage1010$71.25$4,812.7$6,092.7185.5×
midlands choice36$96$96$11,755122.4×
millard public schools36$96$96$11,164116.3×
one world36$96$96$11,164116.3×
greater omaha packing36$96$96$11,164116.3×
Centene35$3,524$4,038$15,5334.4×
bc illinois community24$3,451.83$3,889.22$4,326.611.3×
common ground13$11,455$11,455$11,4551.0×
amps33$7,599$8,708$11,3401.5×
great plains33$3,627$4,156$5,412.481.5×
iamolina33$3,656.64$8,391.76$15,8374.3×
Multiplan33$85$98$981.2×
pace33$3,454$3,958$5,154.741.5×
phcs33$71$98$981.4×
quiktrip33$60$96$961.6×
timpte33$96$96$11,164116.3×
wisconsin physician service13$12,498$13,155$13,1551.1×
Anthem BCBS12$11,471$13,287$15,1041.3×
health alliance22$4,623.58$5,665.51$6,707.431.5×
Cigna22$12,549$13,124$13,6991.1×
coordinated care12$9,292.7$10,019$10,7451.2×
healthpartners12$10,240$10,983$11,7271.1×
providence health plan12$6,040.26$8,679.43$11,3191.9×
meridian health plan22$4,759.57$5,832.14$6,904.711.5×
Ambetter22$5,892.8$7,220.74$8,548.681.5×
todays options11$5,257.84$5,257.84$5,257.841.0×
total care11$8,230.38$8,230.38$8,230.381.0×
quartz group11$13,407$13,407$13,4071.0×
quartz health11$4,577.21$4,577.21$4,577.211.0×
quartz one11$11,458$11,458$11,4581.0×
first choice11$12,697$12,697$12,6971.0×
health payment systems11$11,520$11,520$11,5201.0×
hs technology11$12,791$12,791$12,7911.0×
everpointe elite11$10,793$10,793$10,7931.0×
creighton university employees11$10,567$10,567$10,5671.0×
trilogy11$12,748$12,748$12,7481.0×
Kaiser Permanente11$5,807.94$5,807.94$5,807.941.0×
community health plan of washington11$6,388.73$6,388.73$6,388.731.0×
community health plan11$9,292.7$9,292.7$9,292.71.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
CHI HEALTH MERCY COUNCIL BLUFFSCOUNCIL BLUFFSIA20$60$9,708$14,722
CHI HEALTH MERCY CORNINGCORNINGIA18$60$97$15,837
CHI HEALTH - MISSOURI VALLEYMISSOURI VALLEYIA19$57$96$8,391.76
JONES REGIONAL MEDICAL CTRANAMOSAIA2$8,739.22$9,238.61$9,737.99
AVERA HOLY FAMILY HEALTHESTHERVILLEIA13$75$9,184.43$14,633
IOWA LUTHERAN HOSPITALDES MOINESIA8$69.22$71.25$9,737.99
OTTUMWA REGIONAL HEALTH CENTEROTTUMWAIA1$34,204$13,682$5,587.37$7,088.78$8,590.18
TRINITY MUSCATINEMUSCATINEIA12$3,451.83$6,904.71$9,737.99
UNITYPOINT HEALTH-MARSHALLTOWNMARSHALLTOWNIA10$4,518.14$6,005.67$9,737.99
IOWA METHODIST MEDICAL CENTERDES MOINESIA11$4,863.31$5,501.27$9,737.99
TRINITY REGIONAL MEDICAL CENTERFORT DODGEIA8$4,801.75$5,476.02$9,737.99
TRINITY BETTENDORFBETTENDORFIA12$4,623.58$5,326.19$9,737.99
GRUNDY COUNTY MEM. HOSPITALGRUNDY CENTERIA11$4,439.57$5,253.52$9,737.99
ALLEN MEMORIAL HOSPITALWATERLOOIA11$4,439.57$5,253.52$9,737.99
THE FINLEY HOSPITALDUBUQUEIA15$3,451.83$4,866.15$9,737.99
ST. LUKES METHODIST HOSPITALCEDAR RAPIDSIA11$4,485.25$4,828.51$9,737.99
GRINNELL REGIONAL MEDICAL CENTERGRINNELLIA11$4,206.14$4,329.85$9,737.99
COMMUNITY MEM. HOSPT. SUMMERSUMNERIA11$4,206.14$4,329.85$9,737.99
ST. LUKES REGL MEDICAL CENTERSIOUX CITYIA11$4,206.14$4,329.85$9,737.99
WASHINGTON COUNTY HOSPITALWASHINGTONIA16$9,364.16$12,498$15,104
MERCY HOSPITAL IOWA CITYIOWA CITYIA0

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.