Simple pneumonia and pleurisy with major complications in South Dakota
What 9 hospitals in South Dakota 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
$41,361
Hospital list price billed
Average payment
$11,284
Medicare + patient + other payers
Medicare paid
$9,665
Average per stay
State rank
#23 of 50
1 = lowest average payment
Hospitals in South Dakota billed an average of $41,361 for simple pneumonia and pleurisy with major complications, about 3.7 times the average total payment of $11,284. That payment is 6% 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 $11,284Billed $41,361
About 27¢ was paid for every $1 hospitals in South Dakota billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in South Dakota:
South Dakota hospitals: simple pneumonia and pleurisy with major complications
Every South 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 |
|---|---|---|---|---|
| Avera McKennan Hospital & University Health CenterSioux Falls | 127 | $50,123 | $10,765 | $8,817 |
| Rapid City Regional HospitalRapid City | 116 | $36,087 | $12,800 | $11,301 |
| Sanford Usd Medical CenterSioux Falls | 112 | $53,257 | $11,100 | $9,396 |
| Prairie Lakes Hosp & Care CtrWatertown | 37 | $18,170 | $10,547 | $9,488 |
| Avera St LukesAberdeen | 23 | $38,696 | $9,277 | $7,731 |
| Sanford Medical Center AberdeenAberdeen | 22 | $23,885 | $10,310 | $8,756 |
| Avera Sacred Heart HospitalYankton | 18 | $29,734 | $11,442 | $10,319 |
| Brookings HospitalBrookings | 14 | $29,579 | $9,242 | $7,960 |
| Spearfish Regional HospitalSpearfish | 13 | $29,405 | $13,674 | $12,047 |
Lowest and highest payments in South 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
| Brookings HospitalBrookings, SD | $9,242 |
|---|---|
| Avera St LukesAberdeen, SD | $9,277 |
| Sanford Medical Center AberdeenAberdeen, SD | $10,310 |
| Prairie Lakes Hosp & Care CtrWatertown, SD | $10,547 |
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | $10,765 |
Highest
| Spearfish Regional HospitalSpearfish, SD | $13,674 |
|---|---|
| Rapid City Regional HospitalRapid City, SD | $12,800 |
| Avera Sacred Heart HospitalYankton, SD | $11,442 |
| Sanford Usd Medical CenterSioux Falls, SD | $11,100 |
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | $10,765 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in South Dakota?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 9 hospitals in South Dakota was billed at $41,361 on average, while the average total payment was $11,284, of which Medicare paid $9,665. 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 South Dakota, 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.