Simple pneumonia and pleurisy without complications in Illinois
What 5 hospitals in Illinois charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy without complications (DRG 195), from 2024 Medicare claims.
Average charge
$24,591
Hospital list price billed
Average payment
$6,463
Medicare + patient + other payers
Medicare paid
$3,477
Average per stay
State rank
#13 of 16
1 = lowest average payment
Hospitals in Illinois billed an average of $24,591 for simple pneumonia and pleurisy without complications, about 3.8 times the average total payment of $6,463. That payment is 7% above 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 $6,463Billed $24,591
About 26¢ was paid for every $1 hospitals in Illinois billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Illinois:
Illinois hospitals: simple pneumonia and pleurisy without complications
Every Illinois hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Evanston HospitalEvanston | 30 | $22,312 | $5,837 | $3,993 |
| Northwest Community HospitalArlington Heights | 13 | $20,740 | $7,997 | $2,536 |
| Sarah Bush Lincoln Health CenterMattoon | 12 | $20,774 | $4,752 | $3,530 |
| Advocate Condell Medical CenterLibertyville | 12 | $28,327 | $5,052 | $3,553 |
| Northwestern Medicine McHenryMcHenry | 11 | $35,444 | $9,763 | $3,039 |
Lowest and highest payments in Illinois
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
| Sarah Bush Lincoln Health CenterMattoon, IL | $4,752 |
|---|---|
| Advocate Condell Medical CenterLibertyville, IL | $5,052 |
| Evanston HospitalEvanston, IL | $5,837 |
| Northwest Community HospitalArlington Heights, IL | $7,997 |
| Northwestern Medicine McHenryMcHenry, IL | $9,763 |
Highest
| Northwestern Medicine McHenryMcHenry, IL | $9,763 |
|---|---|
| Northwest Community HospitalArlington Heights, IL | $7,997 |
| Evanston HospitalEvanston, IL | $5,837 |
| Advocate Condell Medical CenterLibertyville, IL | $5,052 |
| Sarah Bush Lincoln Health CenterMattoon, IL | $4,752 |
Simple pneumonia and pleurisy without complications in other states
Questions
How much does simple pneumonia and pleurisy without complications cost in Illinois?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy without complications (DRG 195) at 5 hospitals in Illinois was billed at $24,591 on average, while the average total payment was $6,463, of which Medicare paid $3,477. 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 Illinois, average charges were 3.8 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.