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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
4
Min
$4,722.32
Median
$6,170.6
Max
$13,551
Range multiplier
2.9×

By payer (22 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare38$4,722.32$7,957.71$16,4343.5×
Aetna26$5,332.16$8,038.13$13,3502.5×
Anthem BCBS25$5,634.66$11,357$16,9953.0×
Humana24$5,559.06$5,710.31$19,9773.6×
workers compensation33$6,989.98$7,409.37$7,409.371.1×
Medicare33$4,722.32$4,931.83$5,828.021.2×
sentara health plan12$5,956.14$9,210.7$12,4652.1×
Cigna12$13,551$14,013$14,4761.1×
martins point11$9,728.09$9,728.09$9,728.091.0×
Medicaid11$4,309.91$4,309.91$4,309.911.0×
Self-Pay (Cash)11$5,828.02$5,828.02$5,828.021.0×
TRICARE11$9,728.09$9,728.09$9,728.091.0×
connecticare11$14,074$14,074$14,0741.0×
vhn11$16,084$16,084$16,0841.0×
vhn - link11$18,095$18,095$18,0951.0×
vhn - plus11$15,481$15,481$15,4811.0×
vhn - secondary payors11$19,100$19,100$19,1001.0×
vhn - ultra11$12,465$12,465$12,4651.0×
WellCare11$5,634.66$5,634.66$5,634.661.0×
gateway - tier 311$13,672$13,672$13,6721.0×
gateway - tier 211$16,084$16,084$16,0841.0×
gateway - tier 111$19,100$19,100$19,1001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
RUMFORD HOSPITALRUMFORDME2$4,931$4,931.83$6,170.6$7,409.37
CENTRAL MAINE MEDICAL CENTERLEWISTONME11$5,828$4,309.91$5,828.02$11,357
BRIDGTON HOSPITALBRIDGTONME3$4,722$4,722.32$4,722.32$7,409.37
FRANKLIN MEMORIAL HOSPITALFARMINGTONME15$20,105$7,036.84$5,332.16$13,551$19,977

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.