Simple pneumonia and pleurisy with major complications in Kentucky
What 55 hospitals in Kentucky 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
$43,836
Hospital list price billed
Average payment
$9,950
Medicare + patient + other payers
Medicare paid
$8,151
Average per stay
State rank
#5 of 50
1 = lowest average payment
Hospitals in Kentucky billed an average of $43,836 for simple pneumonia and pleurisy with major complications, about 4.4 times the average total payment of $9,950. That payment is 17% below 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 $9,950Billed $43,836
About 23¢ was paid for every $1 hospitals in Kentucky billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Kentucky:
Kentucky hospitals: simple pneumonia and pleurisy with major complications
Every Kentucky hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Norton Healthcare PavilionLouisville | 284 | $50,104 | $9,620 | $7,932 |
| Baptist Hospital EastLouisville | 176 | $44,717 | $8,576 | $7,016 |
| King's Daughters' Medical CenterAshland | 137 | $37,446 | $8,956 | $7,536 |
| Hardin Memorial HospitalElizabethtown | 125 | $50,427 | $9,165 | $7,609 |
| Central Baptist HospitalLexington | 122 | $48,091 | $8,954 | $7,341 |
| Jewish HospitalLouisville | 110 | $32,431 | $10,542 | $8,024 |
| Owensboro Medical Health SystemOwensboro | 107 | $29,399 | $11,948 | $9,608 |
| St Elizabeth Med Center-SouthEdgewood | 102 | $30,881 | $9,861 | $7,273 |
| Pikeville Medical CenterPikeville | 102 | $58,205 | $11,786 | $10,426 |
| Western Baptist HospitalPaducah | 89 | $45,155 | $9,578 | $8,104 |
| The Medical Center at Bowling GreenBowling Green | 82 | $41,184 | $10,515 | $8,435 |
| Ephraim McDowell Regional Medical CenterDanville | 78 | $30,644 | $8,921 | $7,216 |
| T J Samson Community HospitalGlasgow | 77 | $20,775 | $10,002 | $8,616 |
| Lake Cumberland Regional HospitalSomerset | 69 | $79,587 | $9,944 | $8,288 |
| Saint Joseph HospitalLexington | 68 | $38,000 | $9,516 | $7,645 |
| University of Kentucky HospLexington | 66 | $54,155 | $13,856 | $10,010 |
| St Elizabeth FlorenceFlorence | 65 | $25,232 | $9,980 | $7,036 |
| Saint Joseph LondonLondon | 53 | $44,935 | $9,102 | $8,025 |
| Baptist Health Deaconess MadisonvilleMadisonville | 51 | $48,976 | $10,022 | $8,223 |
| Lourdes HospitalPaducah | 51 | $42,576 | $9,267 | $7,944 |
| Murray-Calloway County HospitalMurray | 45 | $36,797 | $10,551 | $9,501 |
| Baptist Regional Medical CtrCorbin | 43 | $49,841 | $9,091 | $7,441 |
| Baptist Health RichmondRichmond | 40 | $46,255 | $9,447 | $8,157 |
| Greenview Regional HospitalBowling Green | 40 | $64,325 | $9,457 | $6,934 |
| Hazard Arh Regional Medical CenterHazard | 38 | $68,885 | $9,482 | $8,164 |
| Saint Joseph Mount SterlingMt Sterling | 38 | $34,455 | $10,515 | $9,441 |
| Williamson Arh HospitalSouth Williamson | 33 | $43,277 | $10,310 | $9,432 |
| Deaconess Henderson HospitalHenderson | 32 | $31,130 | $9,388 | $8,319 |
| Clark Regional Medical CenterWinchester | 32 | $65,608 | $9,000 | $7,726 |
| St Elizabeth Ft ThomasFort Thomas | 30 | $32,480 | $9,906 | $6,824 |
| Muhlenberg Community HospitalGreenville | 29 | $19,540 | $9,856 | $8,731 |
| Flaget Memorial HospitalBardstown | 29 | $35,351 | $10,897 | $8,895 |
| The Medical Center at RussellvilleRussellville | 29 | $56,858 | $10,224 | $8,986 |
| Jackson Purchase Medical CenterMayfield | 28 | $62,653 | $9,644 | $7,944 |
| Frankfort Regional Medical CenterFrankfort | 28 | $64,710 | $10,199 | $6,892 |
| Whitesburg Arh HospitalWhitesburg | 25 | $50,027 | $9,477 | $7,938 |
| Highlands Regional Medical CenterPrestonsburg | 25 | $48,023 | $8,642 | $7,401 |
| Jennie Stuart Medical CenterHopkinsville | 25 | $35,891 | $9,175 | $8,065 |
| Harlan Appalachian Regional Healthcare HospitalHarlan | 24 | $31,946 | $10,599 | $9,758 |
| Paintsville Arh HospitalPaintsville | 24 | $60,374 | $9,206 | $8,118 |
| Twin Lakes Regional Medical CenterLeitchfield | 23 | $26,327 | $10,027 | $8,539 |
| Kentucky River Medical CenterJackson | 23 | $64,199 | $9,801 | $8,665 |
| Harrison Memorial HospitalCynthiana | 22 | $19,664 | $9,209 | $7,736 |
| Jewish Hospital - ShelbyvilleShelbyville | 21 | $27,750 | $11,671 | $10,194 |
| St Claire Regional Medical CenterMorehead | 20 | $28,497 | $9,733 | $8,382 |
| Meadowview Regional Medical CenterMaysville | 20 | $42,533 | $9,794 | $8,815 |
| University of Louisville HospitalLouisville | 20 | $76,266 | $20,297 | $9,958 |
| Baptist Hospital NortheastLa Grange | 18 | $30,937 | $10,948 | $9,497 |
| Saint Joseph EastLexington | 16 | $28,723 | $10,591 | $8,517 |
| Spring View HospitalLebanon | 15 | $45,238 | $10,386 | $8,863 |
| Three Rivers Medical CenterLouisa | 15 | $57,898 | $10,283 | $8,978 |
| Middlesboro Appalachian Regional Healthcare HospitMiddlesboro | 14 | $46,451 | $10,562 | $9,396 |
| Taylor Regional HospitalCampbellsville | 14 | $31,112 | $10,839 | $9,557 |
| Bourbon Community HospitalParis | 13 | $39,273 | $9,022 | $7,515 |
| Georgetown Community HospitalGeorgetown | 12 | $60,047 | $9,656 | $6,967 |
Lowest and highest payments in Kentucky
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
| Baptist Hospital EastLouisville, KY | $8,576 |
|---|---|
| Highlands Regional Medical CenterPrestonsburg, KY | $8,642 |
| Ephraim McDowell Regional Medical CenterDanville, KY | $8,921 |
| Central Baptist HospitalLexington, KY | $8,954 |
| King's Daughters' Medical CenterAshland, KY | $8,956 |
Highest
| University of Louisville HospitalLouisville, KY | $20,297 |
|---|---|
| University of Kentucky HospLexington, KY | $13,856 |
| Owensboro Medical Health SystemOwensboro, KY | $11,948 |
| Pikeville Medical CenterPikeville, KY | $11,786 |
| Jewish Hospital - ShelbyvilleShelbyville, KY | $11,671 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Kentucky?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 55 hospitals in Kentucky was billed at $43,836 on average, while the average total payment was $9,950, of which Medicare paid $8,151. 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 Kentucky, average charges were 4.4 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.