Other respiratory system diagnoses without major complications in Pennsylvania
What 7 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for other respiratory system diagnoses without major complications (DRG 206), from 2024 Medicare claims.
Average charge
$95,898
Hospital list price billed
Average payment
$9,835
Medicare + patient + other payers
Medicare paid
$7,154
Average per stay
State rank
#3 of 8
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $95,898 for other respiratory system diagnoses without major complications, about 9.8 times the average total payment of $9,835. That payment is 14% below the U.S. average of $11,447.
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 $9,835Billed $95,898
About 10¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: other respiratory system diagnoses without 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 | 32 | $44,313 | $8,138 | $6,499 |
| Temple University HospitalPhiladelphia | 28 | $201,481 | $13,230 | $9,028 |
| UPMC Presbyterian ShadysidePittsburgh | 19 | $126,856 | $10,010 | $6,840 |
| York HospitalYork | 14 | $35,050 | $8,210 | $6,760 |
| Hospital of the Univ of PaPhiladelphia | 14 | $130,761 | $13,646 | $8,221 |
| Main Line Hospital PaoliPaoli | 14 | $51,092 | $6,418 | $5,478 |
| Abington Memorial HospitalAbington | 13 | $26,454 | $7,767 | $6,269 |
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 | $6,418 |
|---|---|
| Abington Memorial HospitalAbington, PA | $7,767 |
| Lehigh Valley HospitalAllentown, PA | $8,138 |
| York HospitalYork, PA | $8,210 |
| UPMC Presbyterian ShadysidePittsburgh, PA | $10,010 |
Highest
| Hospital of the Univ of PaPhiladelphia, PA | $13,646 |
|---|---|
| Temple University HospitalPhiladelphia, PA | $13,230 |
| UPMC Presbyterian ShadysidePittsburgh, PA | $10,010 |
| York HospitalYork, PA | $8,210 |
| Lehigh Valley HospitalAllentown, PA | $8,138 |
Other respiratory system diagnoses without major complications in other states
Questions
How much does other respiratory system diagnoses without major complications cost in Pennsylvania?
In 2024 Medicare data, a hospital stay for other respiratory system diagnoses without major complications (DRG 206) at 7 hospitals in Pennsylvania was billed at $95,898 on average, while the average total payment was $9,835, of which Medicare paid $7,154. 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 9.8 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.