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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
13
Min
$4,749.66
Median
$5,575.57
Max
$8,597.23
Range multiplier
1.8×

By payer (27 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Anthem BCBS1133$4,164.9$8,376.79$8,817.672.1×
UnitedHealthcare1018$3,567.45$5,428.19$8,552.632.4×
Aetna817$3,935.52$5,428.19$8,4522.1×
WellCare815$3,581.81$5,428.19$7,836.942.2×
Humana714$4,164.9$5,341.91$5,575.571.3×
optum ccn region 266$5,428.19$5,428.19$5,575.571.0×
Molina66$4,248.2$4,248.2$5,536.751.3×
optum ccn region 166$5,428.19$5,428.19$5,575.571.0×
Blue Cross Blue Shield14$4,560.65$6,559.52$7,324.821.6×
caresoure kentucky44$9,119.36$9,119.36$9,366.951.0×
umr22$8,552.63$8,552.63$8,552.631.0×
amerihealth12$3,917.41$5,144$6,370.591.6×
the health plan12$4,373.15$4,900.67$5,428.191.2×
trillium11$6,561.71$6,561.71$6,561.711.0×
alliance coal11$7,124.49$7,124.49$7,124.491.0×
va community care network11$4,749.66$4,749.66$4,749.661.0×
vaya11$6,434.3$6,434.3$6,434.31.0×
amerigroup11$4,749.66$4,749.66$4,749.661.0×
alliance11$6,498$6,498$6,4981.0×
Ambetter11$4,485.31$4,485.31$4,485.311.0×
beacon health11$4,142.65$4,142.65$4,142.651.0×
CareSource11$6,412.04$6,412.04$6,412.041.0×
carolina complete11$6,370.59$6,370.59$6,370.591.0×
christian county health dept-cchd11$4,142.65$4,142.65$4,142.651.0×
Cigna11$4,749.66$4,749.66$4,749.661.0×
healthy blue11$6,370.59$6,370.59$6,370.591.0×
partners11$6,370.59$6,370.59$6,370.591.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
OUR LADY OF THE WAYMARTINKY1$8,376.79$8,597.23$8,817.67
BARBOURVILLE ARH HOSPITALBARBOURVILLEKY1$8,376.79$8,597.23$8,817.67
MCDOWELL ARHMCDOWELLKY3$8,376.79$8,552.63$8,817.67
MORGAN CO. ARHWEST LIBERTYKY3$8,376.79$8,552.63$8,817.67
BAPTIST HEALTH LEXINGTONLEXINGTONKY12$3,567.45$6,402.45$8,452
HAZARD ARHHAZARDKY9$4,992.85$5,575.57$9,366.95
TUG VALLEY ARHSOUTH WILLIAMSONKY10$3,956.66$5,428.19$9,119.36
HIGHLANDS REGIONAL MEDICAL CENTERPRESTONSBURGKY8$3,956.66$5,428.19$7,886.51
HARLAN ARHHARLANKY9$3,956.66$5,428.19$9,119.36
WHITESBURG ARHWHITESBURGKY9$3,581.81$5,428.19$9,119.36
PAINTSVILLE ARH HOSPITALPAINTSVILLEKY8$4,885.37$5,428.19$8,817.67
JENNIE STUART MEDICAL CENTERHOPKINSVILLEKY12$3,935.52$4,749.66$7,836.94
SPRING VIEW HOSPITALLEBANONKY0$18,774$7,509.51

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.