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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
30
Min
$95
Median
$5,703.6
Max
$11,732
Range multiplier
123.5×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield2171$2,284$12,024$19,1558.4×
Medicare1044$2,827$5,683.25$10,0973.6×
UnitedHealthcare2143$2,352.52$6,499.91$18,8458.0×
Aetna1327$4,060.01$5,703.6$16,2754.0×
Humana2125$2,720.49$4,349.13$5,817.672.1×
TRICARE1825$1,982$3,761.78$6,334.513.2×
WellCare99$3,941.76$3,941.76$5,703.61.4×
smarthealth99$1,506$5,518.46$7,317.674.9×
Medicare Advantage88$3,941.76$3,941.76$5,140.281.3×
First Health88$7,300$7,300$11,0001.5×
Ambetter88$6,503.9$6,503.9$8,467.591.3×
hap38$4,872.03$5,986.02$11,5072.4×
priority health58$4,207.54$6,605.52$10,7972.6×
healthspring mcr replacement77$4,020.6$4,020.6$4,020.61.0×
blue mcr replacement77$3,941.76$3,941.76$3,941.761.0×
Cigna77$10,470$10,470$10,4701.0×
pcc employee77$10,815$10,815$10,8151.0×
Oscar Health77$6,306.82$6,306.82$6,306.821.0×
occunet77$8,868.96$8,868.96$8,868.961.0×
mi amish medical board77$3,251.04$6,535.74$7,257.182.2×
facility billing - op77$3,941.76$3,941.76$3,941.761.0×
Molina35$4,888.94$5,703.6$7,699.861.6×
bcbsm35$4,872.03$5,703.6$8,064.051.7×
meridian health plan of mi34$6,070.6$6,590.86$7,699.861.3×
mclaren health33$4,872.03$4,892.2$5,703.61.2×
bcbsm/bcn33$8,608.03$9,620.6$10,2911.2×
bcn33$4,872.03$4,892.2$5,703.61.2×
CareSource33$4,872.03$4,892.2$5,703.61.2×
cca health michigan33$4,872.03$4,892.2$5,703.61.2×
vitalcore physicians group of mi33$9,013.26$9,050.57$10,5521.2×
cofinity group health22$8,838.6$10,169$11,4991.3×
pace of se mi22$4,647.59$5,033.01$5,418.421.2×
mount carmel health plan22$4,892.2$5,297.9$5,703.61.2×
amerihealth michigan22$4,794.36$5,191.95$5,589.531.2×
erickson22$4,892.2$5,297.9$5,703.61.2×
harbor health plan11$5,140.28$5,140.28$5,140.281.0×
employer direct healthcare11$7,882.8$7,882.8$7,882.81.0×
Multiplan11$95$95$951.0×
naphcare residential inmate treatment center11$7,967.43$7,967.43$7,967.431.0×
national healthcare solutions, inc11$9,701.9$9,701.9$9,701.91.0×
connect health benefit11$4,568$4,568$4,5681.0×
communitycare (standard)11$2,734.8$2,734.8$2,734.81.0×
communitycare (select)11$2,734.8$2,734.8$2,734.81.0×
community care - st john network senior - govt11$2,284$2,284$2,2841.0×
sunrise11$5,140.28$5,140.28$5,140.281.0×
thomas pace11$4,872.03$4,872.03$4,872.031.0×
total health care priority health11$5,140.28$5,140.28$5,140.281.0×
Bright Health11$6,533.64$6,533.64$6,533.641.0×
u of m health plan11$16,531$16,531$16,5311.0×
united behavioral health11$5,140.28$5,140.28$5,140.281.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
ASPIRUS IRONWOOD HOSPITALIRONWOODMI1$9,952.07$9,952.07$9,952.07
ST. FRANCIS HOSPITALESCANABAMI3$92.5$95$7,829.59
BORGESS-PIPP HEALTH CENTERPLAINWELLMI17$3,761.78$7,300$19,155
ASCENSION BORGESS HOSPITALKALAMAZOOMI17$3,761.78$7,300$19,155
GENESYS REGIONAL MEDICAL CTR.GRAND BLANCMI17$3,761.78$7,300$19,155
ASCENSION PROVIDENCE ROCHESTER HOSPIROCHESTERMI17$3,761.78$7,300$19,155
ASCENSION STANDISH HOSPITALSTANDISHMI17$3,761.78$7,300$19,155
ASCENSION BORGESS-LEE HOSPITALDOWAGIACMI17$3,761.78$7,300$19,155
ASCENSION ALLEGAN HOSPITALALLEGANMI17$3,761.78$7,300$19,155
MCLAREN GREATER LANSINGLANSING MI 489100MI7$29,421$14,711$4,350.35$6,310.59$16,531
MCLAREN CENTRAL MICHIGANMT PLEASANTMI6$12,705$6,352.5$4,343.05$5,884.68$9,981.92
MCLAREN FLINTFLINTMI6$17,619$8,809.56$4,325.63$5,782.83$12,934
HENRY FORD HOSPITALDETROITMI20$4,574.03$5,703.6$12,488
ASPIRUS KEWEENAW HOSPITALLAURIUMMI3$2,720.49$5,703.16$9,654.76
MCLAREN LAPEER REGIONLAPEERMI6$20,527$10,264$4,360.08$5,683.25$9,093.21
ASCENSION ST JOHN HOSPITALDETROITMI13$1,506$5,674.5$18,736
TAWAS ST. JOSEPH HOSPITALTAWASMI9$5,226.91$5,488.26$8,467.59
MCLAREN NORTHERN MICHIGANPETOSKEYMI7$7,284$3,642$4,207.54$5,418.78$8,670.06
GARDEN CITY HOSPITAL OSTEOPATHICGARDEN CITYMI19$6,063$5,140.28$5,268.79$9,701.9
MCLAREN PORT HURONPORT HURONMI5$11,503$5,751.5$4,349.13$4,949.78$7,832.46
W.A. FOOTE MEMORIAL HOSPITALJACKSONMI16$4,872.03$4,945.11$12,488
HENRY FORD HEALTH WYANDOTTE HOSPITALWYANDOTTEMI20$4,571.46$4,892.2$9,191.05
BAY REGIONAL MEDICAL CENTERBAY CITYMI6$18,349$9,174.41$4,276.59$4,848.99$15,383
MCLAREN THUMB REGIONBAD AXEMI5$7,371.5$3,685.75$2,827$2,883.54$5,166.23
ASPIRUS IRON RIVER HOPSITAL & CLINICIRON RIVERMI1$11,732$11,732$11,732
MH - MERCY CAMPUSMUSKEGONMI0
CARSON CITY HOSPITALCARSON CITYMI0$14,338$3,584.58
SPARROW EATONCHARLOTTEMI0$14,338$3,584.58
SPARROW CLINTON HOSPITALST. JOHNSMI0$23,307$5,826.81
NORTH OTTAWA COMMUNITY HOSPITALGRAND HAVENMI0

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.