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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
22
Min
$5,902.04
Median
$9,860.13
Max
$14,500
Range multiplier
2.5×

By payer (48 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield2195$85$9,582.94$22,146260.5×
Aetna2179$4,907.74$15,512$37,5407.6×
UnitedHealthcare2173$5,060.05$13,326$28,7655.7×
horizon971$4,096$14,627$39,4719.6×
Cigna2147$6,210.41$14,726$28,1454.5×
amerihealth2037$4,875.59$11,498$21,3164.4×
WellCare2029$4,907.74$7,472.76$12,9052.6×
qualcare inc815$5,565$6,765$12,7162.3×
Humana1212$4,960.83$5,950.42$8,621.921.7×
wellpoint812$1,885$5,061.58$6,484.93.4×
clover health1111$4,960.83$5,837.08$8,457.691.7×
amerigroup910$4,907.74$5,795.66$9,582.942.0×
clover99$5,398.51$6,242.03$10,5412.0×
oxford99$19,738$20,200$26,5841.3×
brighton health plan99$23,353$23,353$28,8871.2×
seoul medical group99$5,496.67$6,355.52$10,7332.0×
vaccn99$4,515.37$5,139.59$7,492.961.7×
karna99$8,219.64$9,242.08$14,4531.8×
First Health88$60$60$601.0×
Emblem Health88$7,584$9,600$12,2651.6×
fidelis care88$4,960.83$5,645.36$6,484.91.3×
qualcare26$17,360$23,350$23,3501.3×
Medicare46$5,667.07$6,031.27$8,211.351.4×
optum health36$4,733.39$5,978.21$7,472.761.6×
Ambetter44$7,624.65$11,617$16,8332.2×
jefferson health plan33$6,063.76$6,063.76$8,786.141.4×
wellpoint full dual advantage33$5,667.07$5,667.07$8,211.351.4×
oxford health plans33$15,768$15,768$15,7681.0×
braven health33$5,667.07$5,667.07$8,211.351.4×
horizon nj total care33$5,667.07$5,667.07$8,211.351.4×
healthspring33$5,837.08$5,837.08$8,457.691.4×
horizon nj health33$3,900$3,900$3,9001.0×
ubh22$4,918.37$5,417.56$5,916.741.2×
geisinger health plan12$6,693.29$14,313$21,9333.3×
jeff nj amerihealth_ibc12$9,278.41$10,169$11,0591.2×
point of comfort refugee resettlement11$5,971.55$5,971.55$5,971.551.0×
provider partners health plan11$6,389.56$6,389.56$6,389.561.0×
optum va ccn11$5,971.55$5,971.55$5,971.551.0×
naphcare11$9,554.48$9,554.48$9,554.481.0×
Medicare Advantage11$6,154.03$6,154.03$6,154.031.0×
st agnes11$5,971.55$5,971.55$5,971.551.0×
inspira life11$5,971.55$5,971.55$5,971.551.0×
innovage11$6,090.98$6,090.98$6,090.981.0×
va_champus_tricare11$5,971.55$5,971.55$5,971.551.0×
ibc main line health11$7,464.44$7,464.44$7,464.441.0×
ibc employee benefit11$7,464.44$7,464.44$7,464.441.0×
devoted health participation11$6,270.13$6,270.13$6,270.131.0×
allwell pa health_wellness ma11$6,568.71$6,568.71$6,568.711.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
ROBERT WOOD JOHNSON UNIVERSITY HOSPINEW BRUNSWICKNJ13$3,233$60$9,860.13$15,834
ROBERT WOOD JOHNSON HOSPITAL @ HAMIHAMILTONNJ13$3,233$60$9,860.13$15,834
HMH -OCEAN MEDICAL CENTERBRICKNJ14$5,139.59$5,049.51$9,242.08$23,850
INSPIRA MEDICAL CENTER VINELANDVINELANDNJ17$3,900$8,786.14$22,146
JERSEY SHORE UNIVERSITY MED CTRNEPTUNENJ16$5,282.66$4,733.39$6,863.42$39,471
SOUTHERN OCEAN MEDICAL CENTERMANAHAWKINNJ14$4,515.37$4,515.37$6,798.65$23,727
KENNEDY UNIVERSITY HOSPITALCHERRY HILLNJ22$6,888.49$5,971.55$6,568.71$21,933
INSPIRA MEDICAL CENTER ELMERELMERNJ17$3,900$6,063.76$22,146
INSPIRA MEDICAL CENTER WOODBURY INCWOODBURYNJ17$3,900$6,007.09$22,146
BAYSHORE MEDICAL CENTERHOLMDELNJ14$5,282.66$4,574.97$5,941.7$29,091
RARITAN BAY MEDICAL CENTERPERTH AMBOYNJ14$5,282.66$4,574.97$5,941.7$29,091
RIVERVIEW MEDICAL CENTERRED BANKNJ15$5,282.66$4,550.39$5,902.04$23,540
HACKENSACK UNIVERSITY MEDICAL CENTERHACKENSACKNJ16$5,111$14,500$37,540
JFK UNIVERSITY MEDICAL CENTEREDISONNJ16$5,111$14,500$37,540
NEWARK BETH ISRAEL MEDICAL CENTERNEWARKNJ13$3,470$60$12,259$20,206
COOPERMAN BARNABAS MEDICAL CENTERLIVINGSTONNJ13$3,319$60$11,500$18,517
ROBERT WOOD JOHNSON UNIV HOSP @ SOMSOMERVILLENJ13$2,486$60$11,498$22,176
JERSEY CITY MEDICAL CENTERJERSEY CITYNJ13$5,589$60$11,373$18,786
COMMUNITY MEDICAL CENTERTOMS RIVERNJ13$2,426$60$10,825$18,482
PALISADES MEDICAL CENTERNORTH BERGENNJ14$7,492.96$4,096$10,637$25,389
MONMOUTH MEDICAL CENTERLONG BRANCENJ13$3,629$60$10,618$16,619
WEST JERSEY HEALTH SYSTEMVOORHEESNJ0

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.