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Simple pneumonia & pleurisy w/o CC/MCC

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

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Hospitals
43
Min
$2,631.34
Median
$11,500
Max
$19,659
Range multiplier
7.5×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare2672$2,661.80$12,650$19,0727.2×
Anthem BCBS2151$1,886.26$11,471$21,78811.6×
wisconsin physician service1236$12,498$13,155$13,1551.1×
common ground1236$11,455$11,455$11,4551.0×
healthpartners1224$10,240$10,983$11,7271.1×
Molina1819$4,399.13$12,023$12,0232.7×
Humana918$3,303.68$16,327$18,9575.7×
centivo1617$11,716$12,929$17,6881.5×
health payment systems1616$8,116.25$11,520$15,2151.9×
Medicare1416$2,575.37$4,105.97$4,716.751.8×
Cigna1313$12,516$13,699$13,6991.1×
quartz one1212$10,399$11,458$11,4581.1×
trilogy1212$12,748$12,748$12,7481.0×
aurora caregiver1212$11,100$11,100$11,1001.0×
hs technology1212$12,791$12,791$12,7911.0×
quartz group1212$12,168$13,407$13,4071.1×
everpointe elite1212$10,793$10,793$10,7931.0×
Aetna1111$9,364.16$9,364.16$9,364.161.0×
VA Health1111$4,036.60$4,308.05$4,716.751.2×
network health plan57$4,399.13$11,784$13,2083.0×
Blue Cross Blue Shield57$2,611.57$4,519.96$15,4675.9×
smart health77$5,651.24$6,508.19$6,508.191.2×
Medicaid35$201.25$3,745.78$8,002.0639.8×
smarthealth55$5,748.36$11,771$11,7712.0×
security health plan of wisconsin, inc.44$2,708.20$11,465$19,6597.3×
wps33$19,707$19,707$19,7071.0×
quartz health solutions13$4,519.96$6,280.94$9,692.702.1×
quartz23$6,645.78$7,055.81$8,068.121.2×
alliance33$14,865$14,865$14,8651.0×
arise33$17,737$17,737$17,7371.0×
sehn c8933$13,878$13,878$13,8781.0×
cchp marketplace33$14,524$14,524$14,5241.0×
wps health plan22$2,631.34$5,743.94$8,856.543.4×
icare22$4,399.13$5,755.06$7,110.981.6×
health partners12$4,399.13$8,602.10$12,8052.9×
security health plan22$4,399.13$4,459.55$4,519.961.0×
the alliance22$10,013$10,052$10,0911.0×
unitedhealth group of wi12$6,645.78$8,527.73$10,4101.6×
allwell22$4,487.11$4,503.54$4,519.961.0×
WellCare22$4,311.27$4,311.27$4,311.271.0×
healthpartners [900713]22$6,714.27$7,358.17$8,002.061.2×
medical college of wisconsin11$12,663$12,663$12,6631.0×
community care incorporated11$4,399.13$4,399.13$4,399.131.0×
medical associates health plan11$6,382.68$6,382.68$6,382.681.0×
chorus community health plan11$8,643.76$8,643.76$8,643.761.0×
illinicare11$5,256.21$5,256.21$5,256.211.0×
security health plan (shp)11$6,645.78$6,645.78$6,645.781.0×
medica [900156]11$6,313.28$6,313.28$6,313.281.0×
managed health services11$6,645.78$6,645.78$6,645.781.0×
aspirus health plan, inc.11$8,542.61$8,542.61$8,542.611.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Holy Family Memorial IncManitowocWI16$4,399.13$8,750.15$18,518
Beaver Dam Community HospitalsBeaver DamWI12$6,645.78$6,845.15$16,520
Meriter Hospital Inc.MadisonWI12$5,256.21$6,719.25$15,467
Ascension Ne Wisconsin-St. ElizabethAppletonWI6$4,105.97$5,748.36$11,450
Mercy Medical CenterOshkoshWI6$4,105.97$5,748.36$11,450
Howard Young Medical CenterWoodruffWI2$5,355.71$5,413.27$5,470.83
Aspirus Wausau HospitalWausauWI5$1,886.26$4,770.40$11,593
Ascension Se Wisconsin Hospital IncMilwaukeeWI3$4,648.71$4,648.71$6,508.19
Ascension Wisconsin Emerus MenomoneeMenomonee FallsWI3$4,648.71$4,648.71$6,508.19
Wheaton Franciscan - FranklinFranklinWI3$4,648.71$4,648.71$6,508.19
Wfhc - Elmbrook MemorialBrookfieldWI3$4,648.71$4,648.71$6,508.19
Mile Bluff Medical Center Inc.MaustonWI11$4,519.96$4,519.96$10,013
Hudson HospitalHudsonWI6$4,939.00$2,227.98$1,971.62$4,500.10$11,644
Ascension St. Michaels HospitalStevens PointWI2$3,303.68$4,410.45$5,517.22
All Saints - St. Luke S HospitalRacineWI3$4,308.05$4,308.05$6,031.27
Wheaton Franciscan Healthcare - AllRacineWI3$4,308.05$4,308.05$6,031.27
MoshFranklinWI3$4,036.60$4,036.60$5,651.24
Amery Regional Medical CenterAmeryWI4$8,850.00$4,614.39$201.25$3,828.94$3,901.87
Westfields HospitalNew RichmondWI5$2,936.00$1,544.34$3,666.64$3,791.85$8,002.06
Aspirus Langlade HospitalAntigoWI1$2,631.34$2,631.34$2,631.34
Aspirus Medford Hospital And ClinicsMedfordWI1$19,659$19,659$19,659
Childrens Hospital Of Wi-Fox ValleyNeenahWI1$19,072$19,072$19,072
Ssh - Fox ValleyOshkoshWI1$19,072$19,072$19,072
Childrens WisconsinMilwaukeeWI1$18,896$18,896$18,896
Ascension Sacred Heart HospitalTomahawkWI1$17,412$17,412$17,412
Ascension Sacred Heart RehabilitatioMilwaukeeWI12$10,022$15,215$21,788
Ascension Columbia St Marys OzaukeeMequonWI15$4,040.82$15,027$21,788
Ascension Columbia St Marys MilwaukeMilwaukeeWI15$4,716.75$15,027$21,788
West Allis Memorial HospitalWest AllisWI15$10,240$12,525$15,104
Aurora Health Care Metro Inc.MilwaukeeWI16$9,364.16$12,498$15,104
Aurora Medical Center - SummitSummitWI16$9,364.16$12,498$15,104
Aurora Medical Center - HartfordHartfordWI16$9,364.16$12,498$15,104
Sheboygan Memorial HospitalSheboyganWI16$9,364.16$12,498$15,104
Aurora Medical Center Of OshkoshOshkoshWI16$9,364.16$12,498$15,104
Aurora Medical Center GraftonGraftonWI16$9,364.16$12,498$15,104
Memorial Hospital Of BurlingtonBurlingtonWI16$9,364.16$11,727$14,102
Aurora Medical Center KenoshaKenoshaWI16$9,364.16$11,727$13,699
Aurora Lakeland Medical CenterElkhornWI16$9,364.16$11,727$14,102
Aurora Med Ctr Of Manitowoc CountyTwo RiversWI16$9,364.16$11,520$13,948
Aurora Medical Center - Bay AreaMarinetteWI16$7,367.79$11,500$13,699
University Of Wi Hospitals & ClinicsMadisonWI0$16,911
River Falls Area HospitalRiver FallsWI0
Uw Health Rehabilitation HospitalMadisonWI0$16,911

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.