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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
18
Min
$4,126.12
Median
$5,607.66
Max
$11,168
Range multiplier
2.7×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield9118$95.00$10,197$19,449204.7×
UnitedHealthcare969$45.00$6,965.00$32,388719.7×
Medicaid135$3,359.34$3,570.98$4,115.251.2×
Aetna934$29.10$58.80$6,418.23220.6×
Cigna932$25.20$6,291.87$12,367490.8×
Medicare326$4,664.33$4,664.33$6,511.251.4×
Molina517$3,359.34$4,732.13$9,813.412.9×
Humana914$90.00$5,230.08$6,379.9870.9×
no fault [114001]114$5,039.28$5,039.28$5,039.281.0×
absolute total care412$2,020.00$5,230.08$13,7296.8×
WellCare210$4,208.64$4,436.49$4,664.331.1×
select health410$4,871.31$5,888.04$38,5487.9×
univera healthcare [100169]19$6,913.89$9,877.42$9,877.421.4×
clover insurance company36$4,824.91$5,046.60$5,831.971.2×
devoted health35$4,208.64$4,639.34$4,852.501.2×
univera healthcare essential [100170]15$3,359.34$3,359.34$3,359.341.0×
select health of sc [4877]44$5,783.32$8,317.70$10,8521.9×
Multiplan44$90.00$90.00$11,147123.9×
VA Health14$4,615.62$4,664.33$4,664.331.0×
pai [3082]44$10,197$10,682$11,1681.1×
TRICARE13$4,615.62$4,615.62$4,615.621.0×
amedisys hospice13$670.00$670.00$670.001.0×
beacon essential [350122]13$3,127.12$3,413.68$3,413.681.1×
federal workers compensation [500100]13$4,664.33$4,664.33$4,664.331.0×
fidelis essential [100163]13$3,359.34$3,570.98$3,570.981.1×
medcost - sc33$50.44$58.51$9,791.43194.1×
phcs33$90.00$90.00$90.001.0×
plotkin health33$60.00$60.00$60.001.0×
regency hospice13$4,126.12$4,126.12$4,126.121.0×
medcost12$56.90$65.30$73.701.3×
devoted health plan12$5,607.66$5,607.66$5,607.661.0×
nhc advantage12$995.00$2,643.08$4,291.164.3×
apex health12$995.00$2,643.08$4,291.164.3×
umr [3113]22$11,811$11,811$11,8111.0×
first choice vip care plus [4833]22$6,511.25$6,511.25$6,511.251.0×
prime health12$85.00$2,873.02$5,661.0366.6×
pruitt health12$995.00$2,643.08$4,291.164.3×
eon health12$995.00$2,643.08$4,291.164.3×
agape hospice12$525.00$525.00$525.001.0×
sc state employees12$3,889.00$4,598.00$5,307.001.4×
devoted health plan [4501]22$6,201.19$6,201.19$6,201.191.0×
fidelis dual advantage [450120]12$4,664.33$4,664.33$4,664.331.0×
mvp healthcare [100168]11$5,323.99$5,323.99$5,323.991.0×
naphcare11$8,045.93$8,045.93$8,045.931.0×
corvel corporation11$5,661.03$5,661.03$5,661.031.0×
north american administrators11$85.00$85.00$85.001.0×
novanet11$90.00$90.00$90.001.0×
odyssey hospice11$4,126.12$4,126.12$4,126.121.0×
clover11$4,208.64$4,208.64$4,208.641.0×
vocational rehab11$47.00$47.00$47.001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Hilton Head HospitalHilton Head IslandSC14$5,792.00$32.20$5,607.66$32,388
Coastal Carolina Medical CenterHardeevilleSC14$6,353.82$25.20$4,852.50$32,296
East Cooper Regional Medical CenterMt. PleasantSC14$6,237.98$36.90$4,755.33$20,819
Mary Black Memorial HospitalSpartanburgSC28$31,674$12,768$3,127.12$4,664.33$11,569
Colleton Medical CenterWalterboroSC43$45.00$4,126.12$38,548
Bon Secours St. Francis Xavier HospiCharlestonSC11$5,937.41$11,168$12,367
Roper St. Francis Mt Pleasant HospitMt. PleasantSC11$5,937.41$11,168$12,367
Roper Hospital Inc.CharlestonSC7$1,980.00$10,197$12,367
Roper St. Francis Hospital-BerkeleySummervilleSC7$1,980.00$10,197$12,367
Edgefield County HealthcareEdgefieldSC0
Conway HospitalConwaySC0
Mcleod Regional Medical CenterFlorenceSC0
Self Regional HealthcareGreenwoodSC0
Aiken Regional Medical CenterAikenSC0
Mcleod Loris Seacoast HospitalLorisSC0
Mcleod Health CherawCherawSC0
Mcleod Health ClarendonManningSC0
Mcleod Medical Center - DillonDillonSC0

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.