Simple pneumonia & pleurisy w/o CC/MCC in Massachusetts
What Massachusetts hospitals charge for simple pneumonia & pleurisy w/o cc/mcc (MS-DRG 195). Rates sourced from federally-mandated machine-readable files.
Hospitals
16
Rate rows
253
Neg. median
$6,484.9
Min
$60
Max
$20,206
Cash median
$13,404
Across 16 Massachusetts hospitals, the negotiated rate for Simple pneumonia & pleurisy w/o CC/MCC ranges from $60 to $20,206, with a median of $6,484.9. The interquartile range is $6,008.16 to $8,239.1. Cash-pay patients typically pay $13,404; gross charges median $16,936.
By payer in Massachusetts
Top 30 payers for Simple pneumonia & pleurisy w/o CC/MCC in Massachusetts.
| Payer | Hospitals | Rates | Median rate |
|---|---|---|---|
| Blue Cross Blue Shield | 8 | 29 | $7,983.05 |
| UnitedHealthcare | 8 | 25 | $6,901.54 |
| Cigna | 6 | 13 | $6,206.5 |
| Aetna | 5 | 11 | $6,464.2 |
| fallon mcaid carelon hlth [29] | 4 | 4 | $1,939.47 |
| institution [10406] | 4 | 7 | $6,034.51 |
| tufts [11201] | 4 | 6 | $6,958 |
| fallon connectorcare [10503] | 4 | 4 | $9,290.1 |
| wellpoint [11112] | 4 | 4 | $6,905.35 |
| senior whole health [10110] | 4 | 4 | $6,744.44 |
| hsno/free care [10801] | 4 | 4 | $7,197.74 |
| tufts connectorcare [10507] | 4 | 4 | $8,239.1 |
| mgb mcr [10124] | 4 | 4 | $6,475.2 |
| correctional care [11003] | 3 | 6 | $7,172.41 |
| Medicare | 3 | 3 | $8,239.1 |
| commonwealth care mcr [10115] | 3 | 3 | $6,772.54 |
| Humana | 3 | 3 | $6,088.89 |
| fallon mcr [10105] | 3 | 3 | $6,772.54 |
| tufts dual [10111] | 3 | 3 | $8,239.1 |
| tufts mcr supp [20209] | 2 | 2 | $6,772.54 |
| harvard pilgrim mcr supp [20203] | 2 | 2 | $6,772.54 |
| tufts mcr [10112] | 2 | 2 | $6,321.03 |
| WellCare | 2 | 2 | $9,456.56 |
| fallon mcr supp [20202] | 2 | 2 | $6,321.03 |
| fallon carelon hlth [28] | 2 | 2 | $1,637.86 |
| eternalhealth mcr replace [10116] | 2 | 2 | $6,772.54 |
| amerihealth | 2 | 4 | $9,595.79 |
| hne [11108] | 2 | 2 | $3,685 |
| Medicaid | 2 | 2 | $2,023.88 |
| health partners plans | 1 | 1 | $6,207.12 |
Hospital comparison — Simple pneumonia & pleurisy w/o CC/MCC in Massachusetts
Sorted by lowest negotiated median rate. Up to 100 hospitals.
| Hospital | City | Negotiated median | Cash rate | Gross charge |
|---|---|---|---|---|
| High Point Hospital | Middleborough | $6,008.16 | — | — |
| Hospital For Behavioral Medicine | Worcester | $6,023.22 | — | — |
| Healthalliance-Clinton | Leominster | $6,034.51 | $13,404 | $13,404 |
| Harrington Memorial Hospital | Southbridge | $6,156.38 | $10,242 | $10,242 |
| Chestnut Hill Benevolent Association | Chestnut Hill | $6,207.12 | — | — |
| Umass Memorial Medical Center | Worcester | $6,901.54 | $20,468 | $20,468 |
| Marlborough Hospital | Marlborough | $6,901.54 | $20,468 | $20,468 |
| Beth Israel Deaconess - Plymouth | Plymouth | $12,259 | $3,470 | — |
| Baystate Medical Center | Springfield | — | — | — |
| Fairview Hospital | Great Barrington | — | — | — |
| Baystate Wing Hospital & Medical Ctr | Palmer | — | — | — |
| Baystate Franklin Medical Center | Greenfield | — | — | — |
| North Shore Medical Center | Salem | — | — | — |
| Berkshire Medical Center | Pittsfield | — | — | — |
| North Adams Regional Hospital | North Adams | — | — | — |
| Baystate Noble Hospital | Westfield | — | — | — |