Simple pneumonia and pleurisy without complications in Pennsylvania
What 4 hospitals in Pennsylvania charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy without complications (DRG 195), from 2024 Medicare claims.
Average charge
$27,382
Hospital list price billed
Average payment
$5,553
Medicare + patient + other payers
Medicare paid
$3,373
Average per stay
State rank
#7 of 16
1 = lowest average payment
Hospitals in Pennsylvania billed an average of $27,382 for simple pneumonia and pleurisy without complications, about 4.9 times the average total payment of $5,553. That payment is 8% 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 $5,553Billed $27,382
About 20¢ was paid for every $1 hospitals in Pennsylvania billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Pennsylvania:
Pennsylvania hospitals: simple pneumonia and pleurisy without complications
Every Pennsylvania hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Abington Memorial HospitalAbington | 18 | $21,140 | $5,593 | $3,471 |
| Lehigh Valley HospitalAllentown | 17 | $33,439 | $5,814 | $4,100 |
| Grand View HospitalSellersville | 12 | $20,883 | $4,680 | $2,831 |
| Main Line Hospital Bryn Mawr CampusBryn Mawr | 11 | $35,324 | $6,040 | $2,680 |
Lowest and highest payments in Pennsylvania
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
| Grand View HospitalSellersville, PA | $4,680 |
|---|---|
| Abington Memorial HospitalAbington, PA | $5,593 |
| Lehigh Valley HospitalAllentown, PA | $5,814 |
| Main Line Hospital Bryn Mawr CampusBryn Mawr, PA | $6,040 |
Highest
| Main Line Hospital Bryn Mawr CampusBryn Mawr, PA | $6,040 |
|---|---|
| Lehigh Valley HospitalAllentown, PA | $5,814 |
| Abington Memorial HospitalAbington, PA | $5,593 |
| Grand View HospitalSellersville, PA | $4,680 |
Simple pneumonia and pleurisy without complications in other states
Questions
How much does simple pneumonia and pleurisy without complications cost in Pennsylvania?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy without complications (DRG 195) at 4 hospitals in Pennsylvania was billed at $27,382 on average, while the average total payment was $5,553, of which Medicare paid $3,373. 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 Pennsylvania, average charges were 4.9 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.