Simple pneumonia and pleurisy with complications in Pennsylvania
What 80 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$40,799
Hospital list price billed
Average payment
$7,325
Medicare + patient + other payers
Medicare paid
$5,261
Average per stay
State rank
#19 of 47
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $40,799 for simple pneumonia and pleurisy with complications, about 5.6 times the average total payment of $7,325. That payment is 8% 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 $7,325Billed $40,799
About 18¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: simple pneumonia and pleurisy with 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 | 118 | $47,429 | $7,645 | $5,722 |
| Chester County HospitalWest Chester | 76 | $36,283 | $6,072 | $4,631 |
| Abington Memorial HospitalAbington | 73 | $26,258 | $7,034 | $5,381 |
| St Mary Medical CenterLanghorne | 64 | $22,767 | $6,928 | $5,213 |
| Main Line Hospital PaoliPaoli | 63 | $52,323 | $5,839 | $4,460 |
| Temple University HospitalPhiladelphia | 57 | $94,754 | $10,982 | $7,892 |
| UPMC Pinnacle HospitalsHarrisburg | 57 | $32,680 | $7,544 | $4,941 |
| Main Line Hospital Bryn Mawr CampusBryn Mawr | 56 | $47,301 | $6,473 | $4,720 |
| Reading Hospital and Med CtrWest Reading | 45 | $35,188 | $7,335 | $5,757 |
| Lancaster General HospitalLancaster | 45 | $26,280 | $6,931 | $5,185 |
| Grand View HospitalSellersville | 41 | $29,117 | $5,919 | $4,454 |
| Robert Packer HospitalSayre | 40 | $31,798 | $7,823 | $5,675 |
| Hospital of the Univ of PaPhiladelphia | 40 | $123,613 | $15,688 | $10,204 |
| Riddle Memorial HospitalMedia | 38 | $56,105 | $6,091 | $4,359 |
| York HospitalYork | 37 | $27,445 | $7,790 | $5,461 |
| Wayne Memorial HospitalHonesdale | 37 | $33,211 | $7,060 | $5,914 |
| Main Line Hospital LankenauWynnewood | 34 | $51,252 | $8,069 | $5,600 |
| Doylestown HospitalDoylestown | 33 | $21,395 | $6,927 | $3,986 |
| Holy Redeemer Hosp and Med CtrJenkintown | 32 | $21,037 | $6,233 | $4,948 |
| Lansdale HospitalLansdale | 31 | $24,951 | $5,491 | $4,228 |
| Pocono Medical CenterEast Stroudsburg | 30 | $41,579 | $6,791 | $5,101 |
| Hanover HospitalHanover | 30 | $34,092 | $6,842 | $4,916 |
| Milton S Hershey Medical CenterHershey | 30 | $37,877 | $9,788 | $6,938 |
| Geisinger-Community Medical CenterScranton | 29 | $60,502 | $6,787 | $5,057 |
| St Luke's Hospital BethlehemBethlehem | 29 | $62,402 | $9,016 | $5,793 |
| Hamot Medical CenterErie | 28 | $51,844 | $7,636 | $5,929 |
| Dubois Regional Medical CenterDubois | 28 | $14,828 | $6,194 | $4,693 |
| Thomas Jefferson University HospitalPhiladelphia | 28 | $37,206 | $10,427 | $6,776 |
| Phoenixville HospitalPhoenixville | 27 | $41,908 | $6,772 | $5,454 |
| Chambersburg HospitalChambersburg | 27 | $19,293 | $7,338 | $5,055 |
| Jefferson Health- NortheastPhiladelphia | 26 | $25,070 | $8,080 | $5,230 |
| Jefferson Einstein Montgomery HospitalEast Norriton | 26 | $26,481 | $7,847 | $5,531 |
| Chestnut Hill HospitalPhiladelphia | 25 | $96,099 | $8,179 | $6,248 |
| Northwest Medical CenterOil City | 25 | $25,050 | $5,986 | $4,494 |
| St Joseph Medical CenterReading | 25 | $31,824 | $7,034 | $5,122 |
| Williamsport Hospital & Medical CenterWilliamsport | 24 | $31,110 | $6,727 | $4,661 |
| UPMC Presbyterian ShadysidePittsburgh | 24 | $93,971 | $9,785 | $5,894 |
| Holy Spirit HospitalCamp Hill | 23 | $30,861 | $7,133 | $4,015 |
| Meadville Medical CenterMeadville | 22 | $22,860 | $6,419 | $4,364 |
| Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia | 22 | $60,536 | $8,409 | $6,282 |
| Geisinger Wyoming Vly Med CtrWilkes-Barre | 22 | $71,043 | $7,394 | $5,770 |
| Evangelical Community HospitalLewisburg | 21 | $45,483 | $5,670 | $4,194 |
| UPMC PassavantPittsburgh | 21 | $37,977 | $5,475 | $3,593 |
| Uniontown HospitalUniontown | 20 | $26,172 | $6,447 | $4,668 |
| UPMC St MargaretPittsburgh | 20 | $51,143 | $7,316 | $4,522 |
| Wilkes-Barre General HospitalWilkes-Barre | 20 | $54,114 | $5,605 | $3,989 |
| Jefferson Regional Medical CenterClairton | 20 | $31,876 | $5,590 | $4,124 |
| Altoona Regional Health SystemAltoona | 19 | $31,129 | $6,487 | $5,135 |
| Pottstown Memorial Med CenterPottstown | 19 | $52,875 | $5,897 | $4,696 |
| UPMC HorizonGreenville | 19 | $33,675 | $6,393 | $5,087 |
| Saint Vincent Health CenterErie | 18 | $34,209 | $7,269 | $5,859 |
| Heritage Valley SewickleySewickley | 18 | $13,808 | $5,933 | $4,088 |
| Lewistown HospitalLewistown | 18 | $39,651 | $7,812 | $5,193 |
| Western Pennsylvania Hosp Forbes Regional CampusMonroeville | 18 | $31,869 | $5,951 | $4,382 |
| Mount Nittany Medical CenterState College | 18 | $28,559 | $8,076 | $5,511 |
| St Luke's Hospital - Anderson CampusEaston | 18 | $59,998 | $9,361 | $6,448 |
| Geisinger Medical CenterDanville | 17 | $54,228 | $9,003 | $6,867 |
| Heritage Valley BeaverBeaver | 17 | $12,395 | $6,545 | $4,895 |
| Washington Hospital, theWashington | 17 | $12,144 | $6,250 | $4,637 |
| Schuylkill Medical Center - South Jackson StreetPottsville | 16 | $38,599 | $7,055 | $4,850 |
| UPMC MemorialYork | 16 | $37,446 | $6,694 | $4,176 |
| Excela Health Westmoreland Regional HospitalGreensburg | 16 | $18,657 | $6,079 | $4,255 |
| Butler Health SystemButler | 16 | $21,991 | $6,116 | $4,894 |
| St Clair Memorial HospitalPittsburgh | 16 | $14,878 | $5,401 | $3,875 |
| St Luke's Hospital - Monroe CampusStroudsburg | 16 | $63,527 | $6,324 | $4,847 |
| UPMC MercyPittsburgh | 14 | $44,911 | $8,872 | $6,260 |
| Clarion HospitalClarion | 14 | $13,859 | $8,361 | $6,071 |
| Mercy Hospital ScrantonScranton | 14 | $49,413 | $6,239 | $4,501 |
| Penn State Health Lancaster Medical CenterLancaster | 14 | $31,334 | $7,320 | $3,951 |
| Carlisle Regional Medical CtrCarlisle | 13 | $38,407 | $5,817 | $4,311 |
| Conemaugh Valley Memorial HospitalJohnstown | 13 | $23,980 | $7,210 | $6,231 |
| UPMC BedfordEverett | 13 | $20,855 | $7,080 | $5,699 |
| Penn State Health Hampden Medical CenterEnola | 13 | $26,774 | $9,341 | $3,760 |
| Lehigh Valley Hospital - Dickson CityDickson City | 13 | $36,149 | $7,643 | $3,611 |
| St Luke's Quakertown HospitalQuakertown | 12 | $84,067 | $7,494 | $4,799 |
| Latrobe Area HospitalLatrobe | 12 | $22,288 | $6,683 | $4,762 |
| Gettysburg HospitalGettysburg | 11 | $25,389 | $6,314 | $4,978 |
| Excela Health Frick HospitalMt Pleasant | 11 | $21,474 | $5,669 | $4,631 |
| Penn Presbyterian Medical CenterPhiladelphia | 11 | $50,774 | $9,089 | $7,157 |
| UPMC EastMonroeville | 11 | $44,890 | $5,798 | $3,661 |
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
| St Clair Memorial HospitalPittsburgh, PA | $5,401 |
|---|---|
| UPMC PassavantPittsburgh, PA | $5,475 |
| Lansdale HospitalLansdale, PA | $5,491 |
| Jefferson Regional Medical CenterClairton, PA | $5,590 |
| Wilkes-Barre General HospitalWilkes-Barre, PA | $5,605 |
Highest
| Hospital of the Univ of PaPhiladelphia, PA | $15,688 |
|---|---|
| Temple University HospitalPhiladelphia, PA | $10,982 |
| Thomas Jefferson University HospitalPhiladelphia, PA | $10,427 |
| Milton S Hershey Medical CenterHershey, PA | $9,788 |
| UPMC Presbyterian ShadysidePittsburgh, PA | $9,785 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in Pennsylvania?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 80 hospitals in Pennsylvania was billed at $40,799 on average, while the average total payment was $7,325, of which Medicare paid $5,261. 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 5.6 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.