Simple pneumonia and pleurisy without complications in Michigan
What 1 hospital in Michigan charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy without complications (DRG 195), from 2024 Medicare claims.
Average charge
$21,701
Hospital list price billed
Average payment
$4,523
Medicare + patient + other payers
Medicare paid
$2,807
Average per stay
Volume
13
Medicare hospital stays
Hospitals in Michigan billed an average of $21,701 for simple pneumonia and pleurisy without complications, about 4.8 times the average total payment of $4,523. That payment is 25% below 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 $4,523Billed $21,701
About 21¢ was paid for every $1 hospitals in Michigan billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Michigan:
Michigan hospitals: simple pneumonia and pleurisy without complications
Every Michigan hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| William Beaumont Hospital-TroyTroy | 13 | $21,701 | $4,523 | $2,807 |
Simple pneumonia and pleurisy without complications in other states
Questions
How much does simple pneumonia and pleurisy without complications cost in Michigan?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy without complications (DRG 195) at 1 hospital in Michigan was billed at $21,701 on average, while the average total payment was $4,523, of which Medicare paid $2,807. 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 Michigan, average charges were 4.8 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.