Simple pneumonia and pleurisy with complications in North Dakota
What 4 hospitals in North Dakota charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$20,210
Hospital list price billed
Average payment
$7,473
Medicare + patient + other payers
Medicare paid
$4,857
Average per stay
State rank
#23 of 47
1 = lowest average payment
Hospitals in North Dakota billed an average of $20,210 for simple pneumonia and pleurisy with complications, about 2.7 times the average total payment of $7,473. That payment is 6% 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 $7,473Billed $20,210
About 37¢ was paid for every $1 hospitals in North Dakota billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in North Dakota:
North Dakota hospitals: simple pneumonia and pleurisy with complications
Every North Dakota hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Sanford Medical Center FargoFargo | 48 | $19,615 | $7,319 | $5,505 |
| Sanford Medical Center BismarckBismarck | 36 | $21,821 | $7,908 | $4,300 |
| Altru Health SystemGrand Forks | 15 | $20,668 | $7,624 | $4,526 |
| Essentia Health-FargoFargo | 14 | $17,622 | $6,720 | $4,424 |
Lowest and highest payments in North Dakota
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
| Essentia Health-FargoFargo, ND | $6,720 |
|---|---|
| Sanford Medical Center FargoFargo, ND | $7,319 |
| Altru Health SystemGrand Forks, ND | $7,624 |
| Sanford Medical Center BismarckBismarck, ND | $7,908 |
Highest
| Sanford Medical Center BismarckBismarck, ND | $7,908 |
|---|---|
| Altru Health SystemGrand Forks, ND | $7,624 |
| Sanford Medical Center FargoFargo, ND | $7,319 |
| Essentia Health-FargoFargo, ND | $6,720 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in North Dakota?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 4 hospitals in North Dakota was billed at $20,210 on average, while the average total payment was $7,473, of which Medicare paid $4,857. 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 Dakota, average charges were 2.7 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.