Simple pneumonia and pleurisy with major complications in Hawaii
What 11 hospitals in Hawaii charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with major complications (DRG 193), from 2024 Medicare claims.
Average charge
$50,698
Hospital list price billed
Average payment
$16,180
Medicare + patient + other payers
Medicare paid
$13,328
Average per stay
State rank
#49 of 50
1 = lowest average payment
Hospitals in Hawaii billed an average of $50,698 for simple pneumonia and pleurisy with major complications, about 3.1 times the average total payment of $16,180. That payment is 35% above the U.S. average of $12,020.
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 $16,180Billed $50,698
About 32¢ was paid for every $1 hospitals in Hawaii billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Hawaii:
Hawaii hospitals: simple pneumonia and pleurisy with major complications
Every Hawaii hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| The Queens Medical CenterHonolulu | 94 | $61,644 | $16,004 | $12,050 |
| Pali Momi Medical CenterAiea | 79 | $47,557 | $14,246 | $11,109 |
| Hilo Medical CenterHilo | 64 | $50,002 | $16,865 | $14,351 |
| Straub Clinic and HospitalHonolulu | 59 | $53,559 | $14,155 | $11,387 |
| Maui Memorial Medical CenterWailuku | 49 | $42,188 | $21,342 | $19,583 |
| Wilcox Memorial HospitalLihue | 27 | $40,573 | $16,488 | $14,978 |
| Castle Medical CenterKailua | 25 | $42,071 | $13,004 | $11,502 |
| Kuakini Medical CenterHonolulu | 23 | $52,381 | $12,890 | $11,609 |
| North Hawaii Community HospitalKamuela | 20 | $48,690 | $18,305 | $11,796 |
| Kona Community HospitalKealakekua | 19 | $62,026 | $22,716 | $20,203 |
| Kaiser Foundation HospitalHonolulu | 16 | $37,409 | $14,429 | $11,989 |
Lowest and highest payments in Hawaii
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
| Kuakini Medical CenterHonolulu, HI | $12,890 |
|---|---|
| Castle Medical CenterKailua, HI | $13,004 |
| Straub Clinic and HospitalHonolulu, HI | $14,155 |
| Pali Momi Medical CenterAiea, HI | $14,246 |
| Kaiser Foundation HospitalHonolulu, HI | $14,429 |
Highest
| Kona Community HospitalKealakekua, HI | $22,716 |
|---|---|
| Maui Memorial Medical CenterWailuku, HI | $21,342 |
| North Hawaii Community HospitalKamuela, HI | $18,305 |
| Hilo Medical CenterHilo, HI | $16,865 |
| Wilcox Memorial HospitalLihue, HI | $16,488 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Hawaii?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 11 hospitals in Hawaii was billed at $50,698 on average, while the average total payment was $16,180, of which Medicare paid $13,328. 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 Hawaii, average charges were 3.1 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.