How much does Pneumonia (with complications) cost?
MS-DRG 194 · Inpatient stay · 1,522 U.S. hospitals publish a price
Cheapest quarter
under $23,503
Typical charge
$31,756
Dearest quarter
over $47,186
Actually paid
$7,905
The middle U.S. hospital bills $31,756 for Pneumonia (with complications). The dearest hospitals charge about 3.8x what the cheapest do for the same coded work. Medicare actually paid about $7,905 per case.
These are charges, not quotes. What you pay depends on your insurance and your own case. The figures matter because the charge is where an uninsured or out-of-network bill starts.
Pneumonia (with complications) cost by state
The middle charge in each state where at least three hospitals publish a price, cheapest first.
| State | Hospitals | Typical charge | Range |
|---|---|---|---|
| Maryland | 37 | $12,677 | $7,783 – $27,206 |
| Massachusetts | 46 | $16,078 | $9,738 – $52,425 |
| Vermont | 3 | $19,036 | $15,768 – $33,523 |
| North Dakota | 4 | $20,141 | $17,622 – $21,821 |
| Rhode Island | 7 | $22,461 | $21,688 – $34,387 |
| Minnesota | 26 | $22,655 | $13,729 – $38,072 |
| Michigan | 42 | $22,889 | $12,983 – $38,268 |
| Alabama | 37 | $23,875 | $8,056 – $91,436 |
| Iowa | 15 | $24,016 | $15,213 – $39,825 |
| New Hampshire | 9 | $24,456 | $21,869 – $33,172 |
| Mississippi | 25 | $24,589 | $9,897 – $101,685 |
| Maine | 8 | $25,324 | $14,128 – $28,201 |
| Arkansas | 25 | $25,870 | $10,547 – $81,967 |
| Ohio | 71 | $26,326 | $13,280 – $51,533 |
| Missouri | 37 | $26,456 | $16,218 – $67,474 |
| Wyoming | 5 | $26,823 | $18,801 – $35,856 |
| West Virginia | 17 | $27,405 | $16,512 – $37,935 |
| Virginia | 42 | $27,847 | $14,583 – $69,119 |
| Wisconsin | 23 | $27,933 | $14,558 – $47,219 |
| North Carolina | 48 | $28,172 | $13,896 – $55,574 |
| Delaware | 5 | $28,248 | $15,608 – $29,054 |
| Nebraska | 7 | $28,287 | $22,253 – $45,871 |
| Indiana | 49 | $28,951 | $17,414 – $55,760 |
| Louisiana | 32 | $29,328 | $17,368 – $57,641 |
| Oregon | 8 | $29,725 | $19,348 – $35,048 |
| Kentucky | 27 | $30,604 | $14,153 – $68,884 |
| Kansas | 14 | $30,714 | $17,339 – $54,974 |
| Oklahoma | 30 | $30,862 | $12,919 – $98,823 |
| Tennessee | 33 | $31,075 | $16,186 – $88,700 |
| South Carolina | 33 | $31,623 | $17,666 – $70,630 |
| South Dakota | 4 | $31,756 | $23,376 – $35,852 |
| Connecticut | 18 | $32,466 | $22,992 – $43,165 |
| Illinois | 67 | $32,989 | $16,063 – $53,768 |
| Georgia | 45 | $33,407 | $18,138 – $76,853 |
| Pennsylvania | 80 | $33,884 | $12,144 – $123,613 |
| New Mexico | 4 | $34,246 | $18,485 – $50,127 |
| Washington | 14 | $35,212 | $26,421 – $44,982 |
| Hawaii | 3 | $35,578 | $27,028 – $51,553 |
| Alaska | 3 | $35,655 | $27,819 – $44,313 |
| New York | 93 | $36,863 | $9,008 – $120,001 |
| Texas | 94 | $39,948 | $18,483 – $130,656 |
| Arizona | 26 | $39,970 | $10,791 – $66,562 |
| Florida | 121 | $49,102 | $15,436 – $127,354 |
| Colorado | 9 | $50,229 | $31,297 – $152,151 |
| New Jersey | 49 | $63,304 | $24,378 – $239,335 |
| California | 109 | $65,875 | $31,094 – $161,184 |
| Nevada | 11 | $94,240 | $32,513 – $138,382 |
Where Pneumonia (with complications) is charged least
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Holy Cross Germantown Hospital
Germantown, MD |
$7,783 | $7,137 |
|
Johns Hopkins Howard County Medical Center
Columbia, MD |
$7,977 | $7,312 |
|
Lake Martin Community Hospital
Dadeville, AL |
$8,056 | $7,439 |
|
Bibb Medical Center
Centreville, AL |
$8,926 | $10,467 |
|
Bertrand Chaffee Hospital
Springville, NY |
$9,008 | $8,120 |
|
Union Hospital Of Cecil County
Elkton, MD |
$9,220 | $8,281 |
|
Suburban Hospital
Bethesda, MD |
$9,487 | $8,494 |
|
Medstar Franklin Square Medical Center
Rosedale, MD |
$9,715 | $8,859 |
|
Baystate Noble Hospital
Westfield, MA |
$9,738 | $6,601 |
|
Meritus Medical Center
Hagerstown, MD |
$9,741 | $9,207 |
|
Neshoba County General Hospital
Philadelphia, MS |
$9,897 | $8,025 |
|
Frederick Health Hospital
Frederick, MD |
$9,956 | $9,111 |
Where it is charged most
Hospitals that performed it at least eleven times, so a single case cannot set the figure.
| Hospital | Charged | Actually paid |
|---|---|---|
|
Capital Health Medical Center - Hopewell
Pennington, NJ |
$239,335 | $12,200 |
|
Capital Health Regional Medical Center
Trenton, NJ |
$231,751 | $9,474 |
|
Carepoint Health - Bayonne Medical Center
Bayonne, NJ |
$204,470 | $10,162 |
|
Regional Medical Center Of San Jose
San Jose, CA |
$161,184 | $10,565 |
|
San Ramon Regional Medical Center
San Ramon, CA |
$157,041 | $8,841 |
|
Doctors Medical Center
Modesto, CA |
$154,982 | $8,800 |
|
Good Samaritan Hospital
San Jose, CA |
$152,200 | $9,849 |
|
Sky Ridge Medical Center
Lone Tree, CO |
$152,151 | $8,324 |
|
Cedars-Sinai Medical Center
Los Angeles, CA |
$146,002 | $12,662 |
|
Uci Health - Los Alamitos
Los Alamitos, CA |
$144,509 | $9,222 |
|
Stanford Health Care
Stanford, CA |
$140,880 | $16,396 |
|
Ucla West Valley Medical Center
West Hills, CA |
$140,853 | $8,683 |
Questions people ask
How much does Pneumonia (with complications) cost in the United States?
Across 1,522 U.S. hospitals, the middle charge for Pneumonia (with complications) is $31,756. Half of hospitals charge less than that and half charge more. The cheapest quarter charge under $23,503 and the dearest quarter over $47,186.
Why do hospitals charge such different amounts for the same procedure?
Because a hospital charge is a list price it sets itself, not a regulated rate. For Pneumonia (with complications), the hospitals in the dearest tenth charge about 3.8x what the cheapest tenth charge for the same coded work. Insurers negotiate their own rates from those lists, which is why the charge and what is actually paid can be very far apart.
Is that what I would actually pay?
No. $7,905 is roughly what Medicare actually paid per case, against an average charge of $38,636. If you have insurance, your plan pays a negotiated rate and you pay your deductible and coinsurance. If you are uninsured or out of network, the hospital's charge is where your bill starts — which is why the gap matters. Ask for a written good-faith estimate before treatment.
What this code covers
CMS records this work as MS-DRG 194: “SIMPLE PNEUMONIA AND PLEURISY WITH CC”. A DRG covers a whole inpatient stay rather than a single item, so the charge includes the room, the procedure and the care around it. Codes that mention complications carry a different, usually higher price.