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Pick a procedure and (optionally) a state or payer. Rates come from each hospital's federally-mandated machine-readable file.

ProcedureHospital (name or CCN)State

Payer

Hospitals

Payers

Negotiated range

$4,697.78 – $12,011

Negotiated median

$6,960.35

MS-DRG 194 Simple pneumonia & pleurisy w CC · Showing 193 of 193 rate rows

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Hospital	ST	Payer	Plan	Setting	Type	Rate
SPRING VIEW HOSPITAL	KY	Chargemaster	N/A	inpatient	gross	$36,214
SPRING VIEW HOSPITAL	KY	Cash pay	N/A	inpatient	cash	$14,485
BARBOURVILLE ARH HOSPITAL	KY	[De-identified Min]	—	inpatient	min	$10,741
MORGAN CO. ARH	KY	[De-identified Min]	—	inpatient	min	$10,741
MCDOWELL ARH	KY	[De-identified Min]	—	inpatient	min	$10,741
MARY BRECKINRIDGE HOSPITAL	KY	[De-identified Min]	—	inpatient	min	$10,741
OUR LADY OF THE WAY	KY	[De-identified Min]	—	inpatient	min	$10,741
HAZARD ARH	KY	[De-identified Min]	—	inpatient	min	$6,561.9
PAINTSVILLE ARH HOSPITAL	KY	[De-identified Min]	—	inpatient	min	$6,264.31
TUG VALLEY ARH	KY	[De-identified Min]	—	inpatient	min	$5,200.07
MIDDLESBORO ARH	KY	[De-identified Min]	—	inpatient	min	$5,200.07
HARLAN ARH	KY	[De-identified Min]	—	inpatient	min	$5,200.07
HIGHLANDS REGIONAL MEDICAL CENTER	KY	[De-identified Min]	—	inpatient	min	$5,200.07
JENNIE STUART MEDICAL CENTER	KY	[De-identified Min]	—	inpatient	min	$5,181.64
WHITESBURG ARH	KY	[De-identified Min]	—	inpatient	min	$4,707.43
BAPTIST HEALTH LEXINGTON	KY	[De-identified Min]	—	inpatient	min	$4,697.78
SPRING VIEW HOSPITAL	KY	[De-identified Min]	—	inpatient	min	$3,148
HAZARD ARH	KY	caresoure kentucky	Commercial	inpatient	negotiated	$12,011
WHITESBURG ARH	KY	caresoure kentucky	Commercial	inpatient	negotiated	$11,693
MIDDLESBORO ARH	KY	caresoure kentucky	Commercial	inpatient	negotiated	$11,693
HARLAN ARH	KY	caresoure kentucky	Commercial	inpatient	negotiated	$11,693
TUG VALLEY ARH	KY	caresoure kentucky	Commercial	inpatient	negotiated	$11,693
HARLAN ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
WHITESBURG ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
PAINTSVILLE ARH HOSPITAL	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
HAZARD ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
MIDDLESBORO ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
TUG VALLEY ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
MARY BRECKINRIDGE HOSPITAL	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
BARBOURVILLE ARH HOSPITAL	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
MORGAN CO. ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
OUR LADY OF THE WAY	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
MCDOWELL ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$11,307
MCDOWELL ARH	KY	UnitedHealthcare	Commercial	inpatient	negotiated	$10,967
MORGAN CO. ARH	KY	UnitedHealthcare	Commercial	inpatient	negotiated	$10,967
MCDOWELL ARH	KY	umr	Commercial	inpatient	negotiated	$10,967
MORGAN CO. ARH	KY	umr	Commercial	inpatient	negotiated	$10,967
HARLAN ARH	KY	UnitedHealthcare	Commercial	inpatient	negotiated	$10,967
HAZARD ARH	KY	UnitedHealthcare	Commercial	inpatient	negotiated	$10,967
WHITESBURG ARH	KY	UnitedHealthcare	Commercial	inpatient	negotiated	$10,967
MIDDLESBORO ARH	KY	UnitedHealthcare	Commercial	inpatient	negotiated	$10,967
TUG VALLEY ARH	KY	UnitedHealthcare	Commercial	inpatient	negotiated	$10,967
HARLAN ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
PAINTSVILLE ARH HOSPITAL	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
TUG VALLEY ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
WHITESBURG ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
MIDDLESBORO ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
HAZARD ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
BARBOURVILLE ARH HOSPITAL	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
OUR LADY OF THE WAY	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
MORGAN CO. ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
MARY BRECKINRIDGE HOSPITAL	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
MCDOWELL ARH	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,741
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Anthem BCBS	Commercial	inpatient	negotiated	$10,113
JENNIE STUART MEDICAL CENTER	KY	WellCare	Medicare Advantage	inpatient	negotiated	$9,854.69
BAPTIST HEALTH LEXINGTON	KY	Blue Cross Blue Shield	HMO/PPO	inpatient	negotiated	$9,645.66
BAPTIST HEALTH LEXINGTON	KY	Blue Cross Blue Shield	Blue Value	inpatient	negotiated	$9,163.5
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Anthem BCBS	Commercial	inpatient	negotiated	$9,101.29
JENNIE STUART MEDICAL CENTER	KY	alliance coal	Commercial	inpatient	negotiated	$8,958.81
BAPTIST HEALTH LEXINGTON	KY	trillium	Medicaid Tailored Plan	inpatient	negotiated	$8,640.76
BAPTIST HEALTH LEXINGTON	KY	alliance	Medicaid Tailored Plan	inpatient	negotiated	$8,556.86
BAPTIST HEALTH LEXINGTON	KY	UnitedHealthcare	Medicaid Managed Care	inpatient	negotiated	$8,472.98
BAPTIST HEALTH LEXINGTON	KY	vaya	Medicaid Tailored Plan	inpatient	negotiated	$8,472.98
BAPTIST HEALTH LEXINGTON	KY	WellCare	Medicaid Managed Care	inpatient	negotiated	$8,472.98
BAPTIST HEALTH LEXINGTON	KY	Aetna	Broad Network	inpatient	negotiated	$8,452
BAPTIST HEALTH LEXINGTON	KY	carolina complete	Medicaid Managed Care	inpatient	negotiated	$8,389.08
BAPTIST HEALTH LEXINGTON	KY	amerihealth	Medicaid Managed Care	inpatient	negotiated	$8,389.08
BAPTIST HEALTH LEXINGTON	KY	partners	Medicaid Tailored Plan	inpatient	negotiated	$8,389.08
BAPTIST HEALTH LEXINGTON	KY	healthy blue	Medicaid Managed Care	inpatient	negotiated	$8,389.08
BAPTIST HEALTH LEXINGTON	KY	Blue Cross Blue Shield	HPN	inpatient	negotiated	$8,112.26
JENNIE STUART MEDICAL CENTER	KY	CareSource	Medicare Advantage	inpatient	negotiated	$8,062.93
HAZARD ARH	KY	optum ccn region 1	Veterans Affairs Plan	inpatient	negotiated	$7,149.32
HAZARD ARH	KY	WellCare	Medicare	inpatient	negotiated	$7,149.32
HAZARD ARH	KY	UnitedHealthcare	Medicare	inpatient	negotiated	$7,149.32
HAZARD ARH	KY	optum ccn region 2	Veterans Affairs Plan	inpatient	negotiated	$7,149.32
HAZARD ARH	KY	Humana	Medicare	inpatient	negotiated	$7,149.32
HAZARD ARH	KY	Aetna	Medicare	inpatient	negotiated	$7,149.32
HAZARD ARH	KY	Anthem BCBS	Medicare Advantage	inpatient	negotiated	$7,149.32
PAINTSVILLE ARH HOSPITAL	KY	Molina	Medicaid	inpatient	negotiated	$7,099.56
HAZARD ARH	KY	Molina	Medicaid	inpatient	negotiated	$7,045.41
TUG VALLEY ARH	KY	Humana	Medicare	inpatient	negotiated	$6,960.35
WHITESBURG ARH	KY	Aetna	Medicare	inpatient	negotiated	$6,960.35
WHITESBURG ARH	KY	Anthem BCBS	Medicare Advantage	inpatient	negotiated	$6,960.35
WHITESBURG ARH	KY	Humana	Medicare	inpatient	negotiated	$6,960.35
WHITESBURG ARH	KY	optum ccn region 1	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
WHITESBURG ARH	KY	optum ccn region 2	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
WHITESBURG ARH	KY	UnitedHealthcare	Medicare	inpatient	negotiated	$6,960.35
WHITESBURG ARH	KY	WellCare	Medicare	inpatient	negotiated	$6,960.35
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Aetna	Medicare	inpatient	negotiated	$6,960.35
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Anthem BCBS	Medicare Advantage	inpatient	negotiated	$6,960.35
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Humana	Medicare	inpatient	negotiated	$6,960.35
HIGHLANDS REGIONAL MEDICAL CENTER	KY	optum ccn region 1	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
HIGHLANDS REGIONAL MEDICAL CENTER	KY	optum ccn region 2	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
HIGHLANDS REGIONAL MEDICAL CENTER	KY	UnitedHealthcare	Medicare	inpatient	negotiated	$6,960.35
HIGHLANDS REGIONAL MEDICAL CENTER	KY	WellCare	Medicare	inpatient	negotiated	$6,960.35
MIDDLESBORO ARH	KY	Aetna	Medicare	inpatient	negotiated	$6,960.35
MIDDLESBORO ARH	KY	Anthem BCBS	Medicare Advantage	inpatient	negotiated	$6,960.35
MIDDLESBORO ARH	KY	Humana	Medicare	inpatient	negotiated	$6,960.35
MIDDLESBORO ARH	KY	optum ccn region 1	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
MIDDLESBORO ARH	KY	optum ccn region 2	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
MIDDLESBORO ARH	KY	UnitedHealthcare	Medicare	inpatient	negotiated	$6,960.35
MIDDLESBORO ARH	KY	WellCare	Medicare	inpatient	negotiated	$6,960.35
HARLAN ARH	KY	Aetna	Medicare	inpatient	negotiated	$6,960.35
HARLAN ARH	KY	Anthem BCBS	Medicare Advantage	inpatient	negotiated	$6,960.35
HARLAN ARH	KY	Humana	Medicare	inpatient	negotiated	$6,960.35
HARLAN ARH	KY	optum ccn region 1	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
HARLAN ARH	KY	optum ccn region 2	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
HARLAN ARH	KY	UnitedHealthcare	Medicare	inpatient	negotiated	$6,960.35
HARLAN ARH	KY	WellCare	Medicare	inpatient	negotiated	$6,960.35
TUG VALLEY ARH	KY	Aetna	Medicare	inpatient	negotiated	$6,960.35
TUG VALLEY ARH	KY	Anthem BCBS	Medicare Advantage	inpatient	negotiated	$6,960.35
TUG VALLEY ARH	KY	optum ccn region 1	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
TUG VALLEY ARH	KY	optum ccn region 2	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
TUG VALLEY ARH	KY	the health plan	Medicare	inpatient	negotiated	$6,960.35
TUG VALLEY ARH	KY	UnitedHealthcare	Medicare	inpatient	negotiated	$6,960.35
TUG VALLEY ARH	KY	WellCare	Medicare	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	Aetna	Medicare	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	Anthem BCBS	Medicaid	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	Anthem BCBS	Medicare Advantage	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	Humana	Medicaid	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	Humana	Medicare	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	optum ccn region 1	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	optum ccn region 2	Veterans Affairs Plan	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	UnitedHealthcare	Medicaid	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	UnitedHealthcare	Medicare	inpatient	negotiated	$6,960.35
PAINTSVILLE ARH HOSPITAL	KY	WellCare	Medicare	inpatient	negotiated	$6,960.35
BAPTIST HEALTH LEXINGTON	KY	Aetna	Whole Health	inpatient	negotiated	$6,955
HAZARD ARH	KY	Anthem BCBS	Medicaid	inpatient	negotiated	$6,907.26
HAZARD ARH	KY	Humana	Medicaid	inpatient	negotiated	$6,907.26
HARLAN ARH	KY	WellCare	Medicaid	inpatient	negotiated	$6,842.19
PAINTSVILLE ARH HOSPITAL	KY	Aetna	Medicaid	inpatient	negotiated	$6,612.33
HAZARD ARH	KY	Aetna	Medicaid	inpatient	negotiated	$6,561.9
HAZARD ARH	KY	WellCare	Medicaid	inpatient	negotiated	$6,561.9
BAPTIST HEALTH LEXINGTON	KY	Aetna	NC+ Preferred	inpatient	negotiated	$6,527
JENNIE STUART MEDICAL CENTER	KY	Aetna	Medicare Advantage	inpatient	negotiated	$6,271.17
PAINTSVILLE ARH HOSPITAL	KY	WellCare	Medicaid	inpatient	negotiated	$6,264.31
BAPTIST HEALTH LEXINGTON	KY	Blue Cross Blue Shield	Blue Local Individual	inpatient	negotiated	$6,005.68
JENNIE STUART MEDICAL CENTER	KY	va community care network	Medicare Advantage	inpatient	negotiated	$5,972.54
JENNIE STUART MEDICAL CENTER	KY	Anthem BCBS	Medicare Advantage HMO/PPO	inpatient	negotiated	$5,972.54
JENNIE STUART MEDICAL CENTER	KY	UnitedHealthcare	Medicare Advantage	inpatient	negotiated	$5,972.54
JENNIE STUART MEDICAL CENTER	KY	amerigroup	Medicare Advantage	inpatient	negotiated	$5,972.54
JENNIE STUART MEDICAL CENTER	KY	WellCare	Medicare Advantage	inpatient	negotiated	$5,972.54
JENNIE STUART MEDICAL CENTER	KY	Cigna	Medicare Advantage	inpatient	negotiated	$5,972.54
JENNIE STUART MEDICAL CENTER	KY	Humana	Medicare Advantage	inpatient	negotiated	$5,972.54
MIDDLESBORO ARH	KY	WellCare	Medicaid	inpatient	negotiated	$5,966.39
BAPTIST HEALTH LEXINGTON	KY	Ambetter	Managed Care	inpatient	negotiated	$5,906.46
TUG VALLEY ARH	KY	the health plan	Medicaid	inpatient	negotiated	$5,747.44
WHITESBURG ARH	KY	Molina	Medicaid	inpatient	negotiated	$5,583.23
TUG VALLEY ARH	KY	Molina	Medicaid	inpatient	negotiated	$5,583.23
HARLAN ARH	KY	Molina	Medicaid	inpatient	negotiated	$5,583.23
MIDDLESBORO ARH	KY	Molina	Medicaid	inpatient	negotiated	$5,583.23
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Molina	Medicaid	inpatient	negotiated	$5,583.23
JENNIE STUART MEDICAL CENTER	KY	Humana	Government	inpatient	negotiated	$5,494.74
TUG VALLEY ARH	KY	Anthem BCBS	Medicaid	inpatient	negotiated	$5,473.76
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Anthem BCBS	Medicaid	inpatient	negotiated	$5,473.76
MIDDLESBORO ARH	KY	Anthem BCBS	Medicaid	inpatient	negotiated	$5,473.76
MIDDLESBORO ARH	KY	Humana	Choice Care	inpatient	negotiated	$5,473.76
TUG VALLEY ARH	KY	Humana	Medicaid	inpatient	negotiated	$5,473.76
HARLAN ARH	KY	Anthem BCBS	Medicaid	inpatient	negotiated	$5,473.76
HARLAN ARH	KY	Humana	Medicaid	inpatient	negotiated	$5,473.76
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Humana	Medicaid	inpatient	negotiated	$5,473.76
WHITESBURG ARH	KY	Humana	Medicaid	inpatient	negotiated	$5,473.76
WHITESBURG ARH	KY	Anthem BCBS	Medicaid	inpatient	negotiated	$5,473.76
JENNIE STUART MEDICAL CENTER	KY	beacon health	Managed Medicaid	inpatient	negotiated	$5,454.36
JENNIE STUART MEDICAL CENTER	KY	christian county health dept-cchd	Commercial	inpatient	negotiated	$5,454.36
JENNIE STUART MEDICAL CENTER	KY	UnitedHealthcare	Managed Medicaid	inpatient	negotiated	$5,454.36
JENNIE STUART MEDICAL CENTER	KY	WellCare	Managed Medicaid	inpatient	negotiated	$5,454.36
TUG VALLEY ARH	KY	WellCare	Medicaid	inpatient	negotiated	$5,364.28
TUG VALLEY ARH	KY	Aetna	Medicaid	inpatient	negotiated	$5,200.07
MIDDLESBORO ARH	KY	Aetna	Medicaid	inpatient	negotiated	$5,200.07
WHITESBURG ARH	KY	Aetna	Medicaid	inpatient	negotiated	$5,200.07
HARLAN ARH	KY	Aetna	Medicaid	inpatient	negotiated	$5,200.07
HIGHLANDS REGIONAL MEDICAL CENTER	KY	Aetna	Medicaid	inpatient	negotiated	$5,200.07
JENNIE STUART MEDICAL CENTER	KY	Aetna	Managed Medicaid	inpatient	negotiated	$5,181.64
BAPTIST HEALTH LEXINGTON	KY	amerihealth	Managed Care	inpatient	negotiated	$5,158.62
WHITESBURG ARH	KY	WellCare	Medicaid	inpatient	negotiated	$4,707.43
BAPTIST HEALTH LEXINGTON	KY	UnitedHealthcare	Managed Care	inpatient	negotiated	$4,697.78
BAPTIST HEALTH LEXINGTON	KY	UnitedHealthcare	IEX Individual	inpatient	negotiated	$4,697.78
SPRING VIEW HOSPITAL	KY	[De-identified Max]	—	inpatient	max	$36,214
HAZARD ARH	KY	[De-identified Max]	—	inpatient	max	$12,011
TUG VALLEY ARH	KY	[De-identified Max]	—	inpatient	max	$11,693
WHITESBURG ARH	KY	[De-identified Max]	—	inpatient	max	$11,693
HARLAN ARH	KY	[De-identified Max]	—	inpatient	max	$11,693
MIDDLESBORO ARH	KY	[De-identified Max]	—	inpatient	max	$11,693
PAINTSVILLE ARH HOSPITAL	KY	[De-identified Max]	—	inpatient	max	$11,307
OUR LADY OF THE WAY	KY	[De-identified Max]	—	inpatient	max	$11,307
BARBOURVILLE ARH HOSPITAL	KY	[De-identified Max]	—	inpatient	max	$11,307
MORGAN CO. ARH	KY	[De-identified Max]	—	inpatient	max	$11,307
MARY BRECKINRIDGE HOSPITAL	KY	[De-identified Max]	—	inpatient	max	$11,307
MCDOWELL ARH	KY	[De-identified Max]	—	inpatient	max	$11,307
HIGHLANDS REGIONAL MEDICAL CENTER	KY	[De-identified Max]	—	inpatient	max	$10,113
JENNIE STUART MEDICAL CENTER	KY	[De-identified Max]	—	inpatient	max	$9,854.69
BAPTIST HEALTH LEXINGTON	KY	[De-identified Max]	—	inpatient	max	$9,645.66

Rates are point-in-time snapshots from each hospital's machine-readable file. Payers can negotiate different rates for different plans within the same network — this view shows the latest snapshot per (hospital, payer, plan, rate type).