Simple pneumonia and pleurisy with complications in North Carolina
What 48 hospitals in North Carolina charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$29,362
Hospital list price billed
Average payment
$7,967
Medicare + patient + other payers
Medicare paid
$5,702
Average per stay
State rank
#33 of 47
1 = lowest average payment
Hospitals in North Carolina billed an average of $29,362 for simple pneumonia and pleurisy with complications, about 3.7 times the average total payment of $7,967. That payment is about the same as 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 $7,967Billed $29,362
About 27¢ was paid for every $1 hospitals in North Carolina billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in North Carolina:
North Carolina hospitals: simple pneumonia and pleurisy with complications
Every North Carolina hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Wakemed, Raleigh CampusRaleigh | 100 | $27,611 | $8,336 | $6,411 |
| ECU Health Medical CenterGreenville | 73 | $23,450 | $8,899 | $5,931 |
| Atrium Health PinevilleCharlotte | 73 | $34,672 | $6,733 | $4,676 |
| Rex HospitalRaleigh | 72 | $20,512 | $6,043 | $4,464 |
| Carolinas Medical Center-NortheastConcord | 71 | $36,047 | $7,826 | $5,278 |
| Firsthealth Moore Regional HospitalPinehurst | 68 | $36,876 | $6,655 | $4,988 |
| Carolinas Medical Center/Behav HealthCharlotte | 65 | $43,645 | $12,976 | $6,932 |
| New Hanover Regional Medical CenterWilmington | 60 | $26,412 | $7,301 | $5,278 |
| Duke University Medical CenterDurham | 59 | $34,829 | $11,659 | $7,489 |
| Iredell Memorial Hospital INCStatesville | 54 | $29,630 | $6,283 | $4,550 |
| Forsyth Memorial HospitalWinston-Salem | 53 | $26,896 | $7,174 | $5,590 |
| North Carolina Baptist HospitalWinston-Salem | 53 | $32,278 | $14,360 | $7,472 |
| Moses H Cone Memorial Hospital, theGreensboro | 53 | $20,539 | $8,631 | $6,337 |
| Carolinas Medical Center-UnionMonroe | 50 | $36,619 | $6,879 | $5,445 |
| Wakemed, Cary HospitalCary | 49 | $33,089 | $5,552 | $4,076 |
| Caromont Regional Medical CenterGastonia | 47 | $32,393 | $6,862 | $5,321 |
| Johnston Memorial HospitalSmithfield | 47 | $28,730 | $6,676 | $5,142 |
| Wayne Memorial HospitalGoldsboro | 46 | $21,587 | $7,048 | $5,512 |
| UNC HospitalsChapel Hill | 45 | $24,187 | $12,661 | $8,491 |
| Cleveland Regional Medical CenterShelby | 38 | $37,351 | $6,877 | $5,375 |
| Carteret General HospitalMorehead City | 38 | $16,794 | $6,979 | $5,575 |
| Duke Regional HospitalDurham | 36 | $21,550 | $8,052 | $6,325 |
| Carolinas Medical Center-LincolnLincolnton | 35 | $34,841 | $7,731 | $6,565 |
| Onslow Memorial HospitalJacksonville | 33 | $23,792 | $7,529 | $6,145 |
| Nash General HospitalRocky Mount | 31 | $27,649 | $6,519 | $4,481 |
| High Point Regional Hlth SystHigh Point | 30 | $27,199 | $7,329 | $5,641 |
| Brunswick Community HospitalSupply | 30 | $27,963 | $6,308 | $5,002 |
| Carolina East Medical CenterNew Bern | 28 | $21,810 | $7,105 | $5,476 |
| Presbyterian HospitalCharlotte | 24 | $35,055 | $7,541 | $5,686 |
| Wilkes Regional Medical CenterNorth Wilkesboro | 23 | $29,354 | $7,151 | $5,874 |
| Carolinas Med Ctr-UniversityCharlotte | 23 | $37,873 | $9,241 | $7,184 |
| Margaret R Pardee Mem HospitalHendersonville | 22 | $19,839 | $6,290 | $4,709 |
| Presbyterian Hospital-MatthewsMatthews | 22 | $32,566 | $6,348 | $5,015 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville | 21 | $35,383 | $7,389 | $5,177 |
| Southeastern Regional Medical CenterLumberton | 21 | $21,510 | $10,555 | $6,351 |
| Presbyterian Hospital HuntersvilleHuntersville | 21 | $28,382 | $6,814 | $4,735 |
| Watauga Medical CenterBoone | 19 | $17,257 | $7,797 | $5,851 |
| Stanly Regional Medical CenterAlbemarle | 18 | $27,309 | $6,897 | $5,446 |
| Cape Fear Valley Medical CenterFayetteville | 17 | $22,810 | $7,758 | $6,149 |
| Roanoke Chowan HospitalAhoskie | 16 | $18,851 | $7,891 | $5,867 |
| Grace Hospital INCMorganton | 15 | $38,418 | $8,123 | $6,139 |
| Haywood Regional Medical CenterClyde | 15 | $30,520 | $6,447 | $4,832 |
| Rowan Regional Medical CenterSalisbury | 14 | $32,883 | $7,008 | $5,257 |
| Frye Regional Medical CenterHickory | 13 | $47,280 | $6,085 | $4,955 |
| Lenoir Memorial HospitalKinston | 12 | $13,896 | $6,277 | $5,053 |
| Alamance Regional Medical CenterBurlington | 11 | $20,402 | $7,368 | $5,927 |
| Randolph HospitalAsheboro | 11 | $55,574 | $7,959 | $6,773 |
| Catawba Valley Medical CenterHickory | 11 | $24,746 | $7,828 | $5,428 |
Lowest and highest payments in North Carolina
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
| Wakemed, Cary HospitalCary, NC | $5,552 |
|---|---|
| Rex HospitalRaleigh, NC | $6,043 |
| Frye Regional Medical CenterHickory, NC | $6,085 |
| Lenoir Memorial HospitalKinston, NC | $6,277 |
| Iredell Memorial Hospital INCStatesville, NC | $6,283 |
Highest
| North Carolina Baptist HospitalWinston-Salem, NC | $14,360 |
|---|---|
| Carolinas Medical Center/Behav HealthCharlotte, NC | $12,976 |
| UNC HospitalsChapel Hill, NC | $12,661 |
| Duke University Medical CenterDurham, NC | $11,659 |
| Southeastern Regional Medical CenterLumberton, NC | $10,555 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in North Carolina?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 48 hospitals in North Carolina was billed at $29,362 on average, while the average total payment was $7,967, of which Medicare paid $5,702. 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 North Carolina, average charges were 3.7 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.