Pennsylvania / Clarion Hospital
CMS certification 390093 · Clarion, PA · 1 entry in CMS's price-transparency list
Clarion Hospital: charges and Medicare payments
Clarion Hospital reported 115 Medicare inpatient stays across 7 DRGs in 2024. Across them it charged 1.29 times what it was paid — among the lower ratios in Pennsylvania, number 117 of 117 hospitals with at least 100 stays (state median 4.27×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 26 stays at an average charge of $15,207, 73% below the national average. It also billed 430 outpatient services, charging 3.5 times what Medicare paid.
- 1Medicare inpatient stays 115
- 2Charge ÷ paid, inpatient 1.29×
- 3Rank in PA (highest ratio = 1) 117 of 117
- 4CMS price-transparency actions 1
Inpatient stays
For the 7 DRGs that can be compared with the national average, Clarion Hospital charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 291 Heart Failure and Shock with MCC | 26 | $15,207 | -73% | $12,571 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 23 | $23,557 | -74% | $19,063 |
| 193 Simple Pneumonia and Pleurisy with MCC | 17 | $18,958 | -68% | $13,151 |
| 194 Simple Pneumonia and Pleurisy with CC | 14 | $13,859 | -64% | $8,361 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $14,045 | -77% | $12,564 |
| 683 Renal Failure with CC | 12 | $13,608 | -67% | $9,252 |
| 177 Respiratory Infections and Inflammations with MCC | 11 | $19,121 | -73% | $15,984 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 229 | $4,653 | $2,221 |
| Comprehensive Observation Services | 151 | $9,729 | $2,573 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 26 | $5,902 | $1,551 |
| Level 2 Urology and Related Services | 12 | $1,298 | $654 |
| Level 2 Intraocular Procedures | 12 | $4,733 | $3,890 |
Against the Pennsylvania average
For Heart Failure and Shock with MCC (DRG 291), Clarion Hospital charged $15,207 on average, 73% less than the Pennsylvania average of $57,362, and was paid $12,571 against a state average of $11,112. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Clarion Hospital charged $23,557 on average, 73% less than the Pennsylvania average of $88,167, and was paid $19,063 against a state average of $16,881. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Clarion Hospital charged $18,958 on average, 68% less than the Pennsylvania average of $59,404, and was paid $13,151 against a state average of $11,319. For Simple Pneumonia and Pleurisy with CC (DRG 194), Clarion Hospital charged $13,859 on average, 65% less than the Pennsylvania average of $39,961, and was paid $8,361 against a state average of $7,319. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $4,653 was 68% below the state average of $14,403. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $9,729 was 55% below the state average of $21,732. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $5,902 was 57% below the state average of $13,651. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,298 was 70% below the state average of $4,364.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Clarion Hospital in Clarion, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-05-09 (CMS case 4443)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.