Simple pneumonia and pleurisy, with CCMS-DRG 194Pulmonology
Median commercial negotiated rate by hospital, from each hospital's own disclosure file.
The same procedure spans a 5.9× price range across 111 Colorado hospitals.
Open in the explorer →
— filter by insurer or region, map it, or compare hospitals side by side.
How to read “% of Medicare”
Medicare’s payment is a hospital-specific benchmark built from CMS files — adjusted for local wages
and case complexity, and roughly pegged to the cost of care. A commercial rate at 300% means a private plan pays
about triple that benchmark for the same care at the same hospital. The gap is negotiation, not quality.
Full methodology →
Median commercial negotiated rateMedicare benchmark
St Lucie Medical Center $27,683vsLakeside Medical Center $4,666 what you pay what your plan pays
Deductible not metearly in the plan year
St Lucie Medical Center
Lakeside Medical Center
$23,017you feel all of it
Deductible met20% coinsurance
St Lucie Medical Center
Lakeside Medical Center
$4,603$18,414 invisible to you
Out-of-pocket max reacheda bad year, or a big surgery
St Lucie Medical Center
Lakeside Medical Center
$0the market goes blind
The gap is $23,017 in every row. The only thing that changes is how much of it
reaches the person choosing. Nobody hid the price — the deductible structure hides the difference,
and a difference nobody feels is a difference nobody shops. Illustration uses a
20% coinsurance plan with no separate facility or professional bill; your own plan governs.
Detail (click headers to sort, or “why” for cost vs price)
*Cost estimates use hospital-level cost-to-charge ratios from federal cost reports and are approximate;
~ marks categories (imaging, labs) where they are least precise. "Plan rows" is how many distinct plan rates the
hospital published; medians over more rows are sturdier.
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Rexroad Analytics · Data: hospital machine-readable files (45 CFR 180, schema v3.0) retrieved October 6, 2026;
Medicare benchmarks from CMS claims data and fee schedules; cost estimates from FY2026 CMS cost-report ratios, labeled as estimates.
Not medical, legal, or benefits advice. Full methodology →
· The American Healthcare Conundrum →