Simple pneumonia and pleurisy with complications in Massachusetts
What 46 hospitals in Massachusetts charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$19,459
Hospital list price billed
Average payment
$8,160
Medicare + patient + other payers
Medicare paid
$6,095
Average per stay
State rank
#36 of 47
1 = lowest average payment
Hospitals in Massachusetts billed an average of $19,459 for simple pneumonia and pleurisy with complications, about 2.4 times the average total payment of $8,160. That payment is 3% above 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 $8,160Billed $19,459
About 42¢ was paid for every $1 hospitals in Massachusetts billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Massachusetts:
Massachusetts hospitals: simple pneumonia and pleurisy with complications
Every Massachusetts hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Southcoast Hospital Group, INCFall River | 147 | $19,761 | $7,197 | $5,585 |
| South Shore HospitalSouth Weymouth | 129 | $13,445 | $6,966 | $5,263 |
| Massachusetts General HospitalBoston | 89 | $43,603 | $12,361 | $7,502 |
| Lowell General HospitalLowell | 75 | $15,351 | $7,510 | $5,629 |
| Newton-Wellesley HospitalNewton Lower Falls | 68 | $21,808 | $7,662 | $5,507 |
| Winchester HospitalWinchester | 68 | $12,674 | $6,587 | $4,986 |
| Sturdy Memorial HospitalAttleboro | 65 | $11,789 | $6,848 | $5,396 |
| Melrosewakefield HealthcareMelrose | 62 | $13,754 | $7,709 | $5,322 |
| Umass Memorial Medical Center INCWorcester | 57 | $32,804 | $11,073 | $8,470 |
| Cape Cod HospitalHyannis | 50 | $20,402 | $8,514 | $7,096 |
| Beth Israel Deaconess Hospital PlymouthPlymouth | 50 | $14,684 | $6,647 | $5,308 |
| Baystate Medical CenterSpringfield | 50 | $13,352 | $9,194 | $7,187 |
| Good Samaritan Medical Center, a Caritas Family HoBrockton | 50 | $11,955 | $7,051 | $5,551 |
| Beverly Hospital CorporationBeverly | 46 | $17,233 | $6,959 | $5,576 |
| Union HospitalLynn | 44 | $20,277 | $8,279 | $6,024 |
| Brigham and Women's HosptialBoston | 44 | $52,425 | $12,037 | $7,188 |
| Healthalliance Hospitals, INCLeominster | 42 | $23,497 | $7,311 | $5,931 |
| Lahey Clinic HospitalBurlington | 38 | $16,831 | $9,238 | $6,569 |
| Falmouth HospitalFalmouth | 37 | $18,762 | $7,025 | $5,230 |
| Milford Regional Medical CenterMilford | 36 | $11,860 | $7,105 | $5,692 |
| Harrington Memorial HospitalSouthbridge | 34 | $15,855 | $7,408 | $5,843 |
| Berkshire Medical Center INCPittsfield | 33 | $19,411 | $9,098 | $7,297 |
| Anna Jaques HospitalNewburyport | 31 | $15,707 | $7,218 | $5,118 |
| Morton Hospital & Medical CenterTaunton | 29 | $12,522 | $6,923 | $5,741 |
| Beth Israel Deaconess Hospital - NeedhamNeedham | 29 | $16,236 | $6,625 | $5,275 |
| Beth Israel Deaconess Medical CenterBoston | 27 | $26,365 | $11,435 | $8,644 |
| Tufts Medical CenterBoston | 26 | $21,082 | $10,779 | $8,104 |
| Baystate Franklin Medical CenterGreenfield | 23 | $13,291 | $7,505 | $5,427 |
| Cooley Dickinson Hospital Inc,TheNorthampton | 22 | $18,169 | $6,374 | $5,039 |
| Saint Anne's Hospital, a Caritas Family HospitalFall River | 22 | $14,016 | $7,451 | $4,985 |
| Holy Family Hospital, a Caritas Family HospitalMethuen | 22 | $13,282 | $8,371 | $5,283 |
| Lawrence General HospitalLawrence | 21 | $19,741 | $8,032 | $6,725 |
| Emerson HospitalConcord | 21 | $15,920 | $7,133 | $4,616 |
| Heywood HospitalGardner | 21 | $15,382 | $7,061 | $5,897 |
| Wing Memorial Hospital and Medical CenterPalmer | 20 | $14,170 | $7,038 | $5,816 |
| Noble HospitalWestfield | 18 | $9,738 | $6,601 | $5,150 |
| Mercy Medical CenterSpringfield | 18 | $13,050 | $7,393 | $5,945 |
| St Vincent HospitalWorcester | 18 | $40,731 | $9,215 | $7,040 |
| Mount Auburn HospitalCambridge | 17 | $20,693 | $9,199 | $7,098 |
| Faulkner HospitalBoston | 17 | $24,830 | $9,023 | $6,408 |
| Brockton HospitalBrockton | 15 | $17,995 | $9,709 | $6,085 |
| Boston Medical Center CorporationBoston | 13 | $23,402 | $16,846 | $13,927 |
| Marlborough HospitalMarlborough | 13 | $13,101 | $6,607 | $5,226 |
| Milton HospitalMilton | 12 | $14,560 | $6,610 | $5,522 |
| Nantucket Cottage HospitalNantucket | 12 | $18,251 | $10,897 | $9,265 |
| Boston Medical Center-BrightonBrighton | 11 | $11,846 | $9,713 | $8,010 |
Lowest and highest payments in Massachusetts
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
| Cooley Dickinson Hospital Inc,TheNorthampton, MA | $6,374 |
|---|---|
| Winchester HospitalWinchester, MA | $6,587 |
| Noble HospitalWestfield, MA | $6,601 |
| Marlborough HospitalMarlborough, MA | $6,607 |
| Milton HospitalMilton, MA | $6,610 |
Highest
| Boston Medical Center CorporationBoston, MA | $16,846 |
|---|---|
| Massachusetts General HospitalBoston, MA | $12,361 |
| Brigham and Women's HosptialBoston, MA | $12,037 |
| Beth Israel Deaconess Medical CenterBoston, MA | $11,435 |
| Umass Memorial Medical Center INCWorcester, MA | $11,073 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in Massachusetts?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 46 hospitals in Massachusetts was billed at $19,459 on average, while the average total payment was $8,160, of which Medicare paid $6,095. 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 Massachusetts, average charges were 2.4 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.