Simple pneumonia and pleurisy with complications in Kentucky
What 27 hospitals in Kentucky charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$30,006
Hospital list price billed
Average payment
$6,348
Medicare + patient + other payers
Medicare paid
$4,469
Average per stay
State rank
#3 of 47
1 = lowest average payment
Hospitals in Kentucky billed an average of $30,006 for simple pneumonia and pleurisy with complications, about 4.7 times the average total payment of $6,348. That payment is 20% below the U.S. average of $7,941.
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 $6,348Billed $30,006
About 21¢ was paid for every $1 hospitals in Kentucky billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Kentucky:
Kentucky hospitals: simple pneumonia and pleurisy with complications
Every Kentucky hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Norton Healthcare PavilionLouisville | 98 | $34,539 | $6,120 | $4,483 |
| Baptist Hospital EastLouisville | 97 | $30,604 | $5,461 | $3,954 |
| Central Baptist HospitalLexington | 70 | $38,961 | $5,967 | $3,965 |
| Hardin Memorial HospitalElizabethtown | 57 | $33,008 | $6,067 | $3,863 |
| St Elizabeth Med Center-SouthEdgewood | 53 | $21,532 | $6,831 | $4,134 |
| The Medical Center at Bowling GreenBowling Green | 41 | $31,020 | $6,701 | $5,144 |
| Jewish HospitalLouisville | 39 | $21,105 | $6,564 | $4,728 |
| Monroe County Medical CenterTompkinsville | 33 | $14,153 | $6,269 | $5,133 |
| King's Daughters' Medical CenterAshland | 32 | $25,975 | $5,975 | $4,105 |
| Pikeville Medical CenterPikeville | 32 | $32,390 | $7,478 | $5,895 |
| St Elizabeth FlorenceFlorence | 32 | $18,348 | $6,156 | $4,068 |
| Western Baptist HospitalPaducah | 32 | $28,204 | $6,054 | $4,506 |
| St Elizabeth Ft ThomasFort Thomas | 27 | $17,855 | $6,628 | $4,193 |
| Lourdes HospitalPaducah | 27 | $29,821 | $6,196 | $4,233 |
| Murray-Calloway County HospitalMurray | 25 | $33,757 | $6,656 | $5,481 |
| Owensboro Medical Health SystemOwensboro | 23 | $24,946 | $7,285 | $5,630 |
| Williamson Arh HospitalSouth Williamson | 20 | $38,952 | $6,521 | $5,236 |
| Ephraim McDowell Regional Medical CenterDanville | 16 | $19,200 | $5,865 | $4,117 |
| Lake Cumberland Regional HospitalSomerset | 16 | $68,884 | $6,467 | $4,804 |
| Taylor Regional HospitalCampbellsville | 15 | $19,245 | $6,781 | $5,366 |
| Baptist Health RichmondRichmond | 14 | $35,985 | $6,093 | $5,044 |
| University of Kentucky HospLexington | 14 | $43,799 | $10,493 | $2,349 |
| Baptist Health Deaconess MadisonvilleMadisonville | 14 | $38,508 | $6,848 | $4,210 |
| Jackson Purchase Medical CenterMayfield | 13 | $38,074 | $6,108 | $4,631 |
| Jennie Stuart Medical CenterHopkinsville | 12 | $26,816 | $5,712 | $4,423 |
| Deaconess Henderson HospitalHenderson | 11 | $16,121 | $6,622 | $4,282 |
| Rockcastle Reg Hospital & Respiratory Care CtrMt Vernon | 11 | $33,692 | $6,929 | $5,670 |
Lowest and highest payments in Kentucky
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
| Baptist Hospital EastLouisville, KY | $5,461 |
|---|---|
| Jennie Stuart Medical CenterHopkinsville, KY | $5,712 |
| Ephraim McDowell Regional Medical CenterDanville, KY | $5,865 |
| Central Baptist HospitalLexington, KY | $5,967 |
| King's Daughters' Medical CenterAshland, KY | $5,975 |
Highest
| University of Kentucky HospLexington, KY | $10,493 |
|---|---|
| Pikeville Medical CenterPikeville, KY | $7,478 |
| Owensboro Medical Health SystemOwensboro, KY | $7,285 |
| Rockcastle Reg Hospital & Respiratory Care CtrMt Vernon, KY | $6,929 |
| Baptist Health Deaconess MadisonvilleMadisonville, KY | $6,848 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in Kentucky?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 27 hospitals in Kentucky was billed at $30,006 on average, while the average total payment was $6,348, of which Medicare paid $4,469. 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 Kentucky, average charges were 4.7 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.