Simple pneumonia and pleurisy without complications in Florida
What 14 hospitals in Florida charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy without complications (DRG 195), from 2024 Medicare claims.
Average charge
$36,268
Hospital list price billed
Average payment
$6,025
Medicare + patient + other payers
Medicare paid
$4,058
Average per stay
State rank
#9 of 16
1 = lowest average payment
Hospitals in Florida billed an average of $36,268 for simple pneumonia and pleurisy without complications, about 6.0 times the average total payment of $6,025. That payment is about the same as the U.S. average of $6,019.
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 $6,025Billed $36,268
About 17¢ was paid for every $1 hospitals in Florida billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Florida:
Florida hospitals: simple pneumonia and pleurisy without complications
Every Florida hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Boca Raton Regional HospitalBoca Raton | 33 | $28,393 | $4,870 | $3,317 |
| Bethesda Memorial HospitalBoynton Beach | 27 | $41,185 | $5,622 | $3,531 |
| Physicians Regional Medical Center - Pine RidgeNaples | 27 | $48,220 | $4,299 | $2,788 |
| Adventhealth OrlandoOrlando | 26 | $45,275 | $6,768 | $3,569 |
| Sarasota Memorial HospitalSarasota | 22 | $29,518 | $5,379 | $3,236 |
| Jackson Health SystemMiami | 21 | $32,686 | $14,730 | $11,822 |
| Naples Community HospitalNaples | 20 | $36,819 | $5,218 | $2,883 |
| Martin Memorial Health SystemsStuart | 19 | $20,430 | $4,483 | $2,928 |
| Lakeland Regional Medical CenterLakeland | 19 | $29,113 | $5,976 | $3,999 |
| Sarasota Memorial Hospital - VeniceNorth Venice | 17 | $32,081 | $4,118 | $2,774 |
| Baptist Medical CenterJacksonville | 15 | $38,921 | $5,641 | $3,965 |
| Lee Memorial HospitalFort Myers | 13 | $28,661 | $5,815 | $4,392 |
| Ocala Regional Medical CenterOcala | 13 | $63,715 | $5,626 | $4,082 |
| Mount Sinai Medical CenterMiami Beach | 12 | $35,705 | $6,029 | $4,494 |
Lowest and highest payments in Florida
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
| Sarasota Memorial Hospital - VeniceNorth Venice, FL | $4,118 |
|---|---|
| Physicians Regional Medical Center - Pine RidgeNaples, FL | $4,299 |
| Martin Memorial Health SystemsStuart, FL | $4,483 |
| Boca Raton Regional HospitalBoca Raton, FL | $4,870 |
| Naples Community HospitalNaples, FL | $5,218 |
Highest
| Jackson Health SystemMiami, FL | $14,730 |
|---|---|
| Adventhealth OrlandoOrlando, FL | $6,768 |
| Mount Sinai Medical CenterMiami Beach, FL | $6,029 |
| Lakeland Regional Medical CenterLakeland, FL | $5,976 |
| Lee Memorial HospitalFort Myers, FL | $5,815 |
Simple pneumonia and pleurisy without complications in other states
Questions
How much does simple pneumonia and pleurisy without complications cost in Florida?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy without complications (DRG 195) at 14 hospitals in Florida was billed at $36,268 on average, while the average total payment was $6,025, of which Medicare paid $4,058. 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 Florida, average charges were 6.0 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.