Diabetes with major complications in Pennsylvania
What 40 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for diabetes with major complications (DRG 637), from 2024 Medicare claims.
Average charge
$71,421
Hospital list price billed
Average payment
$13,208
Medicare + patient + other payers
Medicare paid
$10,537
Average per stay
State rank
#27 of 43
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $71,421 for diabetes with major complications, about 5.4 times the average total payment of $13,208. That payment is 6% below the U.S. average of $14,037.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $13,208Billed $71,421
About 18¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: diabetes with major complications
Every Pennsylvania hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Lehigh Valley HospitalAllentown | 64 | $86,278 | $12,827 | $10,471 |
| Reading Hospital and Med CtrWest Reading | 44 | $56,855 | $12,573 | $11,012 |
| Jefferson Health- NortheastPhiladelphia | 36 | $37,860 | $12,931 | $9,400 |
| Abington Memorial HospitalAbington | 34 | $44,398 | $11,827 | $9,966 |
| Temple University HospitalPhiladelphia | 31 | $151,946 | $18,896 | $13,265 |
| York HospitalYork | 29 | $49,326 | $12,809 | $11,047 |
| St Luke's Hospital BethlehemBethlehem | 29 | $85,696 | $14,459 | $11,918 |
| UPMC Pinnacle HospitalsHarrisburg | 27 | $56,042 | $13,805 | $10,617 |
| Lancaster General HospitalLancaster | 24 | $51,232 | $11,680 | $9,897 |
| Albert Einstein Medical CenterPhiladelphia | 21 | $50,197 | $18,190 | $14,496 |
| Thomas Jefferson University HospitalPhiladelphia | 21 | $58,767 | $16,278 | $12,870 |
| St Luke's Hospital - Anderson CampusEaston | 21 | $112,798 | $16,096 | $11,926 |
| Chestnut Hill HospitalPhiladelphia | 20 | $122,678 | $13,637 | $10,623 |
| St Mary Medical CenterLanghorne | 20 | $48,396 | $11,525 | $9,183 |
| Geisinger Wyoming Vly Med CtrWilkes-Barre | 20 | $76,053 | $12,232 | $10,897 |
| Main Line Hospital Bryn Mawr CampusBryn Mawr | 19 | $79,055 | $11,671 | $9,323 |
| Crozer Chester Medical CenterChester | 18 | $119,896 | $14,293 | $11,861 |
| Geisinger-Community Medical CenterScranton | 16 | $134,349 | $11,903 | $10,281 |
| Milton S Hershey Medical CenterHershey | 16 | $69,721 | $16,367 | $13,295 |
| Chester County HospitalWest Chester | 15 | $50,077 | $10,503 | $9,415 |
| Chambersburg HospitalChambersburg | 14 | $41,433 | $11,257 | $10,547 |
| Main Line Hospital PaoliPaoli | 14 | $65,299 | $8,798 | $7,391 |
| Good Samaritan HospitalLebanon | 13 | $34,923 | $12,613 | $8,236 |
| Altoona Regional Health SystemAltoona | 13 | $44,786 | $11,445 | $10,073 |
| UPMC Presbyterian ShadysidePittsburgh | 13 | $184,105 | $18,722 | $11,377 |
| Main Line Hospital LankenauWynnewood | 13 | $94,881 | $13,702 | $11,680 |
| Doylestown HospitalDoylestown | 13 | $29,563 | $10,157 | $8,988 |
| St Clair Memorial HospitalPittsburgh | 13 | $26,735 | $9,082 | $7,419 |
| Mount Nittany Medical CenterState College | 13 | $37,342 | $13,032 | $11,842 |
| Lansdale HospitalLansdale | 12 | $37,886 | $9,494 | $8,543 |
| Nazareth HospitalPhiladelphia | 12 | $50,964 | $17,668 | $10,722 |
| Hanover HospitalHanover | 12 | $29,909 | $14,559 | $8,016 |
| Geisinger Medical CenterDanville | 11 | $104,977 | $16,625 | $10,104 |
| Schuylkill Medical Center - South Jackson StreetPottsville | 11 | $57,841 | $11,653 | $9,110 |
| Allegheny General HospitalPittsburgh | 11 | $119,134 | $12,586 | $9,567 |
| Grand View HospitalSellersville | 11 | $52,530 | $9,510 | $8,067 |
| Gettysburg HospitalGettysburg | 11 | $44,994 | $10,963 | $10,369 |
| UPMC St MargaretPittsburgh | 11 | $91,192 | $12,655 | $9,860 |
| Mercy Hospital ScrantonScranton | 11 | $64,680 | $10,272 | $8,675 |
| Geisinger St. Luke's HospitalOrwigsburg | 11 | $56,553 | $10,146 | $9,483 |
Lowest and highest payments in Pennsylvania
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Main Line Hospital PaoliPaoli, PA | $8,798 |
|---|---|
| St Clair Memorial HospitalPittsburgh, PA | $9,082 |
| Lansdale HospitalLansdale, PA | $9,494 |
| Grand View HospitalSellersville, PA | $9,510 |
| Geisinger St. Luke's HospitalOrwigsburg, PA | $10,146 |
Highest
| Temple University HospitalPhiladelphia, PA | $18,896 |
|---|---|
| UPMC Presbyterian ShadysidePittsburgh, PA | $18,722 |
| Albert Einstein Medical CenterPhiladelphia, PA | $18,190 |
| Nazareth HospitalPhiladelphia, PA | $17,668 |
| Geisinger Medical CenterDanville, PA | $16,625 |
Diabetes with major complications in other states
Questions
How much does diabetes with major complications cost in Pennsylvania?
In 2024 Medicare data, a hospital stay for diabetes with major complications (DRG 637) at 40 hospitals in Pennsylvania was billed at $71,421 on average, while the average total payment was $13,208, of which Medicare paid $10,537. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in Pennsylvania, average charges were 5.4 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.