Simple pneumonia and pleurisy without complications in New Jersey
What 9 hospitals in New Jersey charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy without complications (DRG 195), from 2024 Medicare claims.
Average charge
$49,031
Hospital list price billed
Average payment
$6,153
Medicare + patient + other payers
Medicare paid
$4,145
Average per stay
State rank
#11 of 16
1 = lowest average payment
Hospitals in New Jersey billed an average of $49,031 for simple pneumonia and pleurisy without complications, about 8.0 times the average total payment of $6,153. That payment is 2% 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 $6,153Billed $49,031
About 13¢ was paid for every $1 hospitals in New Jersey billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in New Jersey:
New Jersey hospitals: simple pneumonia and pleurisy without complications
Every New Jersey hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Virtua West Jersey HospitalVoorhees | 25 | $55,774 | $5,830 | $3,384 |
| Morristown Memorial HospitalMorristown | 16 | $47,433 | $6,445 | $4,728 |
| Valley HospitalRidgewood | 15 | $47,455 | $5,332 | $3,874 |
| Cape Regional Medical Center INCCape May Court House | 12 | $30,595 | $5,166 | $3,656 |
| Englewood Hospital and Medical CenterEnglewood | 12 | $36,544 | $7,048 | $5,175 |
| Saint Barnabas Medical CenterLivingston | 12 | $69,148 | $8,530 | $5,429 |
| University Medical Center at PrincetonPrinceton | 11 | $44,578 | $5,020 | $3,426 |
| Community Medical CenterToms River | 11 | $53,681 | $5,628 | $3,643 |
| Overlook HospitalSummit | 11 | $49,768 | $6,752 | $4,622 |
Lowest and highest payments in New Jersey
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
| University Medical Center at PrincetonPrinceton, NJ | $5,020 |
|---|---|
| Cape Regional Medical Center INCCape May Court House, NJ | $5,166 |
| Valley HospitalRidgewood, NJ | $5,332 |
| Community Medical CenterToms River, NJ | $5,628 |
| Virtua West Jersey HospitalVoorhees, NJ | $5,830 |
Highest
| Saint Barnabas Medical CenterLivingston, NJ | $8,530 |
|---|---|
| Englewood Hospital and Medical CenterEnglewood, NJ | $7,048 |
| Overlook HospitalSummit, NJ | $6,752 |
| Morristown Memorial HospitalMorristown, NJ | $6,445 |
| Virtua West Jersey HospitalVoorhees, NJ | $5,830 |
Simple pneumonia and pleurisy without complications in other states
Questions
How much does simple pneumonia and pleurisy without complications cost in New Jersey?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy without complications (DRG 195) at 9 hospitals in New Jersey was billed at $49,031 on average, while the average total payment was $6,153, of which Medicare paid $4,145. 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 New Jersey, average charges were 8.0 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.