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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
16
Min
$6,008.16
Median
$6,207.12
Max
$12,259
Range multiplier
2.0×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield829$5,520.24$7,983.05$15,9182.9×
UnitedHealthcare825$5,736.40$6,901.54$16,8442.9×
Cigna613$2,759.00$6,206.50$15,5105.6×
Aetna511$3,709.00$6,464.20$20,2065.4×
institution [10406]47$758.07$6,034.51$8,239.1010.9×
tufts [11201]46$2,759.00$6,958.00$7,654.002.8×
correctional care [11003]36$5,883.68$7,172.41$8,844.141.5×
senior whole health [10110]44$6,295.54$6,744.44$6,901.541.1×
amerihealth24$5,131.67$9,595.79$16,6013.2×
fallon connectorcare [10503]44$4,921.00$9,290.10$13,6592.8×
fallon mcaid carelon hlth [29]44$1,252.97$1,939.47$2,064.741.6×
hsno/free care [10801]44$6,034.51$7,197.74$8,239.101.4×
mgb mcr [10124]44$6,156.38$6,475.20$6,772.541.1×
tufts connectorcare [10507]44$6,034.51$8,239.10$8,575.841.4×
wellpoint [11112]44$6,011.00$6,905.35$7,799.691.3×
tufts dual [10111]33$6,034.51$8,239.10$8,239.101.4×
Humana33$5,736.40$6,088.89$6,484.901.1×
commonwealth care mcr [10115]33$6,177.86$6,772.54$6,772.541.1×
fallon mcr [10105]33$6,464.20$6,772.54$6,772.541.0×
medical mutual13$5,736.40$10,566$12,9802.3×
Medicare33$6,034.51$8,239.10$8,239.101.4×
fallon mcr supp [20202]22$6,177.86$6,321.03$6,464.201.0×
Medicaid22$2,023.88$2,023.88$2,023.881.0×
wellpoint12$1,885.00$4,184.95$6,484.903.4×
tufts mcr [10112]22$6,177.86$6,321.03$6,464.201.0×
tufts mcr supp [20209]22$6,772.54$6,772.54$6,772.541.0×
harvard pilgrim mcr supp [20203]22$6,772.54$6,772.54$6,772.541.0×
WellCare22$6,008.16$9,456.56$12,9052.1×
Molina12$6,023.22$9,280.06$12,5372.1×
eternalhealth mcr replace [10116]22$6,772.54$6,772.54$6,772.541.0×
hne [11108]22$3,685.00$3,685.00$3,685.001.0×
fallon carelon hlth [28]22$1,252.60$1,637.86$2,023.121.6×
pennsylvania health and wellness12$6,207.12$6,344.74$6,482.351.0×
qualcare inc12$6,640.00$6,803.00$6,966.001.0×
buckeye health plan12$5,736.40$7,744.14$9,751.881.7×
geisinger12$6,148.00$6,845.00$7,542.001.2×
CareSource12$5,736.40$7,301.01$8,865.611.5×
Ambetter11$5,339.65$5,339.65$5,339.651.0×
alliance11$6,067.65$6,067.65$6,067.651.0×
upmc health plan11$6,207.12$6,207.12$6,207.121.0×
clover health11$6,484.90$6,484.90$6,484.901.0×
commonwealth care alliance [10103]11$6,464.20$6,464.20$6,464.201.0×
carolina complete11$5,948.68$5,948.68$5,948.681.0×
custom design benefits inc.11$13,480$13,480$13,4801.0×
elder health11$7,093.85$7,093.85$7,093.851.0×
devoted health11$5,736.40$5,736.40$5,736.401.0×
Emblem Health11$12,265$12,265$12,2651.0×
valor health plan11$5,736.40$5,736.40$5,736.401.0×
vaya11$6,008.16$6,008.16$6,008.161.0×
fidelis care11$6,484.90$6,484.90$6,484.901.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Marlborough HospitalMarlboroughMA20$20,468$20,468$758.07$6,901.54$13,659
Umass Memorial Medical CenterWorcesterMA20$20,468$20,468$758.07$6,901.54$13,659
Chestnut Hill Benevolent AssociationChestnut HillMA17$5,752.66$6,207.12$12,406
Harrington Memorial HospitalSouthbridgeMA19$10,242$10,242$1,252.60$6,156.38$8,575.84
Healthalliance-ClintonLeominsterMA22$13,404$13,404$758.07$6,034.51$7,894.77
Hospital For Behavioral MedicineWorcesterMA16$5,736.40$6,023.22$13,480
High Point HospitalMiddleboroughMA12$5,131.67$6,008.16$8,893.09
Beth Israel Deaconess - PlymouthPlymouthMA13$3,470.00$60.00$12,259$20,206
Baystate Noble HospitalWestfieldMA0
Baystate Medical CenterSpringfieldMA0
North Shore Medical CenterSalemMA0
Fairview HospitalGreat BarringtonMA0
Baystate Wing Hospital & Medical CtrPalmerMA0
Berkshire Medical CenterPittsfieldMA0
Baystate Franklin Medical CenterGreenfieldMA0
North Adams Regional HospitalNorth AdamsMA0

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.