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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
67
Min
$2,609.99
Median
$6,438.11
Max
$57,374
Range multiplier
22.0×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield53267$3,730.84$6,939.78$60,24316.1×
baylor scott & white health plan23134$4,016.44$6,069.80$13,2563.3×
UnitedHealthcare47121$4,156.85$8,926.30$57,37413.8×
Humana4691$2,609.99$5,413.08$57,37422.0×
Cigna3865$65.00$6,219.53$23,220357.2×
Aetna4255$2,609.99$8,664.00$57,37422.0×
healthsmart2040$2,804.00$5,647.57$8,491.143.0×
Medicare933$3,837.66$5,872.41$8,094.002.1×
american health plan2525$4,439.22$5,080.83$22,9375.2×
procare advantage2424$4,439.22$5,308.43$22,9375.2×
university of mary hardin-baylor2323$5,358.33$5,358.33$5,358.331.0×
prime health services2022$4,429.07$5,900.76$34,8307.9×
superior health plan2121$4,257.85$5,021.04$13,1993.1×
triwest2121$4,227.83$4,838.89$7,364.191.7×
corvel2020$4,429.07$5,794.63$22,8845.2×
Ambetter2020$8,976.08$10,411$23,2202.6×
healthspring1919$4,439.22$5,021.04$7,732.401.7×
Anthem BCBS214$11,641$15,894$19,8671.7×
employers health network1414$6,367.98$6,367.98$6,367.981.0×
baylor scott and white39$6,818.76$10,963$57,3748.4×
sedgwick88$5,376.11$8,330.92$27,1315.0×
commercial | entrust | all plans88$9,617.80$13,894$15,9181.7×
wellmed77$5,413.08$5,413.08$57,37410.6×
commercial | community health choice | exchange77$6,113.01$7,638.92$10,1181.7×
Molina57$5,790.04$6,897.51$83,19314.4×
wellpoint66$7,307.66$7,307.66$21,0832.9×
amerigroup66$4,864.81$12,840$60,53012.4×
commercial | phcs | all plans66$12,303$12,604$12,6041.0×
wellpoint (fka amerigroup)55$5,679.75$6,040.69$7,585.121.3×
commercial | nxhealth | all plans55$13,557$20,119$21,9211.6×
commercial | harris health | ers55$6,113.01$8,808.62$10,1181.7×
commercial | renaissance | all plans55$2,934.24$4,228.14$4,856.401.7×
commercial | superior health plan | all plans55$6,113.01$8,808.62$10,1181.7×
commercial | independent med system | all plans55$8,625.52$8,625.52$8,625.521.0×
injury management organization55$6,009.90$8,753.77$27,1314.5×
careworks fka rockport55$6,009.90$8,753.77$27,1314.5×
commercial | kelseycare | exchange55$5,501.71$7,927.75$9,105.751.7×
90 degree benefits44$13,533$13,533$13,5331.0×
advantage 36024$11,500$11,850$12,2001.1×
caprock44$13,533$13,533$13,5331.0×
city of san angelo44$3,297.20$3,297.20$3,297.201.0×
pdh/texas trust44$8,660.93$8,660.93$8,660.931.0×
commercial | healthsmart | ap344$5,750.19$5,750.19$5,750.191.0×
unified zionsville24$13,965$14,464$14,9631.1×
unified group services24$18,572$19,237$19,9011.1×
prohealth24$7,939.93$7,939.93$7,939.931.0×
insurance services of lubbock44$7,145.27$7,145.27$7,145.271.0×
scott & white44$4,433.62$4,433.62$4,433.621.0×
superior24$10,963$13,114$15,4531.4×
suburban/sho24$7,939.93$7,939.93$7,939.931.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Wilson N Jones Regional Medical CtrShermanTX2$8,739.22$9,238.61$9,737.99
Baylor S&W Medical Center - IrvingIrvingTX18$2,778.00$7,732.40$16,643
Baylor University Medical CtrDallasTX19$2,778.00$7,718.11$16,612
Scott And White Memorial HospitalTempleTX19$2,778.00$7,383.61$12,687
Big Spring State HospitalBig SpringsTX15$3,297.20$7,307.66$13,533
San Angelo Community Medical CenterSan AngeloTX15$3,297.20$7,307.66$13,533
Shannon Medical CenterSan AngeloTX15$3,297.20$7,307.66$13,533
River Crest HospitalSan AngeloTX15$3,297.20$7,307.66$13,533
Hillcrest Baptist Medical CenterWacoTX15$2,778.00$7,087.15$12,149
Baylor Scott & White - Marble FallsMarble FallsTX17$2,778.00$6,982.95$11,998
Scott & White Hospital BrenhamBrenhamTX8$2,778.00$6,939.78$8,664.00
St Lukes Hospital At The VintageHoustonTX16$4,418.65$6,934.34$21,921
Chi St Lukes Health Baylor Med CtrHoustonTX16$3,730.84$6,921.53$19,085
Brazosport Regional Health SystemLake JacksonTX8$4,117.42$6,737.11$15,436
College Station Medical CenterCollege StationTX8$4,949.42$6,661.95$20,119
St. Joseph Regional Health CenterBryanTX8$4,949.42$6,661.95$20,119
St. Lukes Sugar Land HospitalSugar LandTX14$4,418.65$6,659.16$15,407
Madison St. Joseph Health CenterMadisonvilleTX2$4,949.42$6,600.30$8,977.50
Grimes St. Joseph Health CenterNavasotaTX2$4,949.42$6,600.30$8,977.50
College Station HospitalCollege StationTX17$2,778.00$6,438.11$10,603
Burleson St. Joseph Health CenterCaldwellTX1$4,949.42$6,252.80$6,947.79
Baylor S&W All Saints Medical CenterFort WorthTX18$2,778.00$6,157.99$13,264
Chi St Lukes Health Mem LivingstonLivingstonTX6$4,522.00$6,099.87$6,282.87
Baylor Orthopedic And Spine HospitalArlingtonTX2$5,041.11$6,051.89$7,062.66
Baylor S&W Medical Center - MckinneyMckinneyTX17$2,778.00$6,039.52$13,264
Round Rock HospitalRound RockTX19$2,778.00$6,009.90$11,612
Baylor Scott & White Mc- Lake PointeRowlettTX19$2,778.00$6,002.77$14,198
Centennial Medical CenterFriscoTX19$2,778.00$5,790.04$14,198
Tchd D/B/A Jps Health NetworkFort WorthTX13$5,352.88$57,374$83,193
St. Lukes The Woodlands HospitalThe WoodlandsTX15$3,003.39$5,682.25$13,557
Baylor Scott & White Wmc - BrenhamBrenhamTX17$2,778.00$5,618.78$20,963
The Heart Hospital Baylor PlanoPlanoTX17$2,778.00$5,618.78$20,963
Trinity Regional Hospital SachseSachseTX8$4,801.75$5,476.02$9,737.99
Baylor Heart And Vascular HospitalDallasTX12$2,778.00$5,472.29$13,264
St. Lukes Patients Medical CenterPasadenaTX8$4,267.57$5,471.30$12,303
Scott And White Hospital TaylorTaylorTX12$2,778.00$5,434.17$11,612
Bsw Medical Center - AustinAustinTX12$2,778.00$5,434.17$11,612
Mid Coast Medical Center-CentralLlanoTX12$2,778.00$5,434.17$11,612
The Heart Hospital Baylor DentonDentonTX17$2,778.00$5,397.30$20,963
St. Lukes Lakeside HospitalThe WoodlandsTX15$2,934.24$5,389.91$12,604
Chi St Lukes Health Memorial LufkinLufkinTX6$4,522.00$5,380.36$5,900.55
Baylor S&W Medical Center - PlanoPlanoTX17$2,778.00$5,376.55$13,264
Baylor Scott & White PflugervillePflugervilleTX16$2,778.00$5,376.11$11,612
Baylor Scott & White - BudaBudaTX12$2,778.00$5,358.33$11,612
Baylor Medical Center-GrapevineGrapevineTX17$2,778.00$5,332.13$13,264
St Lukes Health Memorial San AugustSan AugustineTX2$4,522.00$5,287.14$6,052.27
Scott & White Cedar ParkCedar ParkTX1$5,080.83$5,080.83$5,080.83
Baylor Scott And White Mc At SunnyvaSunnyvaleTX2$3,781.49$4,879.04$8,324.86
Heritage Park Surgical HospitalShermanTX2$3,781.49$4,174.35$7,365.00
Childrens Medical Center Of PlanoPlanoTX4$2,609.99$2,609.99$2,609.99
Corpus Christi Specialty HospitalCorpus ChristiTX17$23,220$23,220$34,830
Texas Spine And Joint HospitalTylerTX8$2,804.00$22,937$27,131
Baylor Scott & White Continuing CareTempleTX8$2,804.00$22,937$27,131
Acuity Hospital Of South TexasSan AntonioTX20$21,083$21,083$31,624
Ascension Seton Shoal CreekAustinTX16$7,939.93$13,833$19,901
Ascension Seton BastropBastropTX16$7,939.93$13,833$19,901
Covenant Hospital LevellandLevellandTX8$4,257.46$13,688$15,526
Covenant Hospital PlainviewPlainviewTX11$65.00$10,963$11,794
Hospitals Of Providence East CampusEl PasoTX14$70.00$10,219$19,089
St Joseph Medical CenterHoustonTX0
Laredo Medical CenterLaredoTX0
Longview Regional Medical CenterLongviewTX0
Northwest Texas Surgery CenterAmarilloTX0
Northwest Texas HospitalAmarilloTX0
Texoma Medical CenterDenisonTX0
Navarro Regional HospitalCorsicanaTX0
The Medical Ctr Of Southeast TexasPort ArthurTX0

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.