Hospital Costs > In Illinois > Ingalls Memorial Hospital, procedure costs
| Procedure | Discharges | Avg Covered Charges | Avg Total Payment | Avg Medicare Payment | ||||
|---|---|---|---|---|---|---|---|---|
| Count | Rank | Amount | Rank | Amount | Rank | Amount | Rank | |
| Acute Myocardial Infarction, Discharged Alive W Cc | 36 | 55 / 8 | $36.359,90 | 943 / 41 | $7.405,75 | 914 / 43 | $6.410,47 | 912 / 48 |
| Acute Myocardial Infarction, Discharged Alive W Mcc | 44 | 81 / 13 | $41.351,50 | 867 / 31 | $11.181,90 | 967 / 43 | $10.198,90 | 965 / 48 |
| Acute Myocardial Infarction, Expired W Mcc | 11 | 19 / 5 | $50.364,30 | 107 / 4 | $11.235,50 | 79 / 5 | $10.288,50 | 79 / 5 |
| Alcohol/Drug Abuse Or Dependence W Rehabilitation Therapy | 31 | 50 / 6 | $47.550,20 | 77 / 6 | $8.352,90 | 47 / 3 | $7.695,65 | 47 / 3 |
| Alcohol/Drug Abuse Or Dependence W/O Rehabilitation Therapy W/O Mcc | 29 | 95 / 20 | $35.985,20 | 756 / 48 | $5.135,55 | 464 / 17 | $4.308,52 | 463 / 27 |
| Alcohol/Drug Abuse Or Dependence, Left Ama | 40 | 13 / 4 | $24.381,80 | 108 / 13 | $3.733,12 | 36 / 4 | $3.030,05 | 35 / 4 |
| Back & Neck Proc Exc Spinal Fusion W Cc/Mcc Or Disc Device/Neurostim | 14 | 52 / 13 | $75.633,50 | 443 / 27 | $12.170,70 | 248 / 10 | $10.686,40 | 246 / 17 |
| Back & Neck Proc Exc Spinal Fusion W/O Cc/Mcc | 28 | 61 / 7 | $53.310,00 | 608 / 31 | $7.602,57 | 398 / 11 | $5.996,46 | 397 / 25 |
| Bronchitis & Asthma W Cc/Mcc | 12 | 64 / 27 | $22.471,10 | 481 / 22 | $6.183,25 | 694 / 30 | $5.431,00 | 690 / 45 |
| Bronchitis & Asthma W/O Cc/Mcc | 14 | 31 / 9 | $17.562,70 | 172 / 8 | $4.727,71 | 225 / 6 | $3.833,93 | 225 / 9 |
| Cardiac Arrhythmia & Conduction Disorders W Cc | 40 | 121 / 31 | $21.484,40 | 1163 / 37 | $5.752,58 | 1200 / 62 | $4.507,02 | 1196 / 65 |
| Cardiac Arrhythmia & Conduction Disorders W Mcc | 48 | 75 / 18 | $26.658,40 | 769 / 37 | $8.259,50 | 1118 / 59 | $7.400,94 | 1115 / 71 |
| Cardiac Arrhythmia & Conduction Disorders W/O Cc/Mcc | 33 | 117 / 24 | $15.560,50 | 1065 / 40 | $4.245,88 | 1408 / 56 | $3.303,70 | 1402 / 78 |
| Cellulitis W Mcc | 17 | 41 / 16 | $24.527,20 | 232 / 4 | $9.274,76 | 412 / 26 | $8.360,12 | 410 / 28 |
| Cellulitis W/O Mcc | 80 | 109 / 24 | $18.863,30 | 1347 / 57 | $5.861,38 | 1668 / 58 | $4.922,86 | 1661 / 78 |
| Chest Pain | 34 | 117 / 23 | $18.574,70 | 812 / 33 | $4.527,24 | 939 / 37 | $3.447,88 | 934 / 48 |
| Chronic Obstructive Pulmonary Disease W Cc | 76 | 103 / 20 | $27.731,20 | 1604 / 69 | $6.537,30 | 1527 / 61 | $5.556,20 | 1521 / 77 |
| Chronic Obstructive Pulmonary Disease W Mcc | 85 | 117 / 22 | $32.114,70 | 1599 / 64 | $7.991,51 | 1529 / 58 | $6.875,04 | 1522 / 73 |
| Chronic Obstructive Pulmonary Disease W/O Cc/Mcc | 31 | 89 / 23 | $21.985,40 | 1404 / 64 | $5.235,71 | 1455 / 54 | $4.332,61 | 1444 / 74 |
| Circulatory Disorders Except Ami, W Card Cath W Mcc | 16 | 77 / 21 | $41.967,10 | 190 / 6 | $13.674,40 | 483 / 25 | $12.797,20 | 477 / 33 |
| Circulatory Disorders Except Ami, W Card Cath W/O Mcc | 51 | 137 / 21 | $33.294,60 | 670 / 29 | $7.527,35 | 962 / 35 | $6.253,37 | 959 / 57 |
| Cranial & Peripheral Nerve Disorders W/O Mcc | 20 | 48 / 10 | $22.425,70 | 278 / 8 | $6.243,60 | 289 / 17 | $5.002,75 | 289 / 18 |
| Degenerative Nervous System Disorders W Mcc | 12 | 26 / 9 | $57.661,80 | 161 / 10 | $12.388,70 | 108 / 6 | $10.781,80 | 108 / 6 |
| Degenerative Nervous System Disorders W/O Mcc | 39 | 39 / 8 | $29.511,40 | 486 / 27 | $6.729,64 | 415 / 25 | $5.721,13 | 415 / 32 |
| Diabetes W Cc | 40 | 52 / 6 | $22.669,70 | 863 / 41 | $5.837,40 | 875 / 45 | $4.843,88 | 871 / 53 |
| Diabetes W Mcc | 12 | 45 / 11 | $38.216,60 | 434 / 22 | $9.363,67 | 297 / 19 | $8.104,17 | 297 / 17 |
| Digestive Malignancy W Cc | 12 | 35 / 14 | $34.826,50 | 192 / 12 | $8.532,42 | 168 / 15 | $7.447,50 | 166 / 15 |
| Disorders Of Pancreas Except Malignancy W Cc | 11 | 50 / 20 | $20.558,00 | 318 / 6 | $6.468,91 | 631 / 25 | $5.767,64 | 628 / 36 |
| Dysequilibrium | 16 | 49 / 17 | $27.622,10 | 382 / 25 | $4.664,88 | 315 / 15 | $3.643,94 | 315 / 19 |
| Esophagitis, Gastroent & Misc Digest Disorders W Mcc | 24 | 72 / 21 | $24.203,00 | 401 / 11 | $8.137,62 | 750 / 33 | $7.249,04 | 745 / 46 |
| Esophagitis, Gastroent & Misc Digest Disorders W/O Mcc | 90 | 185 / 30 | $20.926,00 | 1497 / 50 | $5.797,46 | 1652 / 76 | $4.280,61 | 1639 / 73 |
| Extensive O.R. Procedure Unrelated To Principal Diagnosis W Mcc | 21 | 42 / 8 | $90.184,50 | 157 / 4 | $29.396,80 | 293 / 10 | $28.666,20 | 293 / 13 |
| G.I. Hemorrhage W Cc | 60 | 158 / 29 | $28.162,70 | 1453 / 59 | $7.090,10 | 1406 / 67 | $5.827,93 | 1403 / 72 |
| G.I. Hemorrhage W Mcc | 32 | 89 / 24 | $36.141,10 | 554 / 21 | $11.005,60 | 689 / 31 | $10.189,20 | 690 / 39 |
| G.I. Hemorrhage W/O Cc/Mcc | 15 | 53 / 14 | $18.307,10 | 480 / 22 | $5.114,40 | 596 / 27 | $4.037,47 | 592 / 33 |
| G.I. Obstruction W Cc | 29 | 63 / 22 | $28.449,40 | 1143 / 58 | $6.315,76 | 1092 / 55 | $5.283,21 | 1089 / 66 |
| G.I. Obstruction W/O Cc/Mcc | 18 | 53 / 19 | $22.531,00 | 928 / 54 | $4.990,17 | 788 / 53 | $3.421,28 | 785 / 47 |
| Heart Failure & Shock W Cc | 176 | 103 / 7 | $23.996,80 | 1587 / 61 | $6.993,81 | 1708 / 76 | $6.006,36 | 1703 / 81 |
| Heart Failure & Shock W Mcc | 128 | 156 / 20 | $40.047,40 | 1661 / 64 | $10.064,80 | 1664 / 61 | $9.403,62 | 1659 / 78 |
| Heart Failure & Shock W/O Cc/Mcc | 46 | 64 / 12 | $17.346,10 | 1087 / 47 | $4.923,09 | 1351 / 64 | $4.153,28 | 1340 / 74 |
| Hip & Femur Procedures Except Major Joint W Cc | 13 | 130 / 50 | $57.473,10 | 1285 / 58 | $12.659,40 | 1211 / 59 | $11.670,40 | 1197 / 68 |
| Hypertension W/O Mcc | 14 | 51 / 16 | $24.448,00 | 519 / 32 | $4.659,86 | 425 / 20 | $3.506,86 | 423 / 22 |
| Infectious & Parasitic Diseases W O.R. Procedure W Mcc | 27 | 97 / 30 | $96.034,40 | 447 / 20 | $30.528,70 | 500 / 20 | $29.493,70 | 496 / 24 |
| Intracranial Hemorrhage Or Cerebral Infarction W Cc Or Tpa In 24 Hrs | 62 | 120 / 22 | $31.819,00 | 1237 / 45 | $7.338,95 | 1284 / 52 | $6.301,26 | 1281 / 70 |
| Intracranial Hemorrhage Or Cerebral Infarction W Mcc | 44 | 124 / 19 | $48.202,80 | 923 / 48 | $11.308,30 | 848 / 39 | $10.412,20 | 846 / 51 |
| Intracranial Hemorrhage Or Cerebral Infarction W/O Cc/Mcc | 14 | 88 / 32 | $30.929,20 | 1136 / 58 | $5.503,14 | 1040 / 42 | $4.427,79 | 1036 / 61 |
| Kidney & Urinary Tract Infections W Mcc | 34 | 110 / 28 | $25.350,60 | 939 / 34 | $7.406,18 | 1125 / 52 | $6.614,26 | 1121 / 62 |
| Kidney & Urinary Tract Infections W/O Mcc | 59 | 174 / 39 | $22.295,80 | 1781 / 69 | $5.503,58 | 1689 / 67 | $4.538,64 | 1678 / 76 |
| Laparoscopic Cholecystectomy W/O C.D.E. W Cc | 12 | 44 / 22 | $52.287,20 | 499 / 21 | $10.960,90 | 552 / 23 | $9.883,00 | 550 / 30 |
| Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/Mcc | 11 | 36 / 13 | $32.235,60 | 188 / 3 | $8.331,73 | 417 / 7 | $7.412,45 | 416 / 19 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Cc | 17 | 56 / 23 | $24.078,00 | 442 / 16 | $7.899,76 | 703 / 39 | $7.335,94 | 701 / 48 |
| Major Gastrointestinal Disorders & Peritoneal Infections W Mcc | 18 | 38 / 13 | $38.673,10 | 276 / 11 | $11.929,40 | 295 / 20 | $11.247,20 | 294 / 28 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc | 14 | 51 / 17 | $73.699,80 | 422 / 15 | $20.100,50 | 489 / 20 | $19.170,50 | 486 / 26 |
| Major Joint Replacement Or Reattachment Of Lower Extremity W/O Mcc | 325 | 247 / 17 | $55.022,00 | 1508 / 53 | $14.261,40 | 1483 / 45 | $12.004,50 | 1449 / 66 |
| Major Small & Large Bowel Procedures W Cc | 21 | 87 / 26 | $66.671,40 | 790 / 24 | $16.180,20 | 884 / 23 | $15.140,60 | 876 / 51 |
| Major Small & Large Bowel Procedures W Mcc | 18 | 67 / 22 | $168.932,00 | 909 / 47 | $39.134,20 | 1004 / 44 | $37.799,60 | 1002 / 58 |
| Major Small & Large Bowel Procedures W/O Cc/Mcc | 12 | 52 / 11 | $47.666,40 | 430 / 14 | $10.873,10 | 474 / 8 | $9.703,67 | 474 / 16 |
| Medical Back Problems W Mcc | 12 | 27 / 11 | $32.395,60 | 90 / 2 | $10.486,80 | 148 / 9 | $9.621,33 | 148 / 13 |
| Medical Back Problems W/O Mcc | 33 | 88 / 27 | $28.209,90 | 951 / 51 | $5.960,45 | 908 / 43 | $4.995,42 | 905 / 56 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W Mcc | 43 | 83 / 17 | $27.296,90 | 823 / 39 | $7.514,56 | 897 / 41 | $6.785,60 | 894 / 57 |
| Misc Disorders Of Nutrition,Metabolism,Fluids/Electrolytes W/O Mcc | 70 | 96 / 20 | $18.452,40 | 1372 / 53 | $5.084,30 | 1664 / 65 | $4.265,21 | 1659 / 77 |
| Nonspecific Cerebrovascular Disorders W Cc | 12 | 44 / 6 | $35.145,90 | 335 / 10 | $6.788,92 | 294 / 9 | $6.114,25 | 294 / 12 |
| Nonspecific Cerebrovascular Disorders W Mcc | 13 | 38 / 4 | $39.863,20 | 191 / 7 | $10.095,80 | 144 / 5 | $9.469,38 | 144 / 6 |
| Organic Disturbances & Mental Retardation | 16 | 43 / 14 | $25.534,80 | 286 / 19 | $6.545,12 | 199 / 13 | $5.666,44 | 199 / 12 |
| Other Circulatory System Diagnoses W Cc | 13 | 53 / 15 | $25.584,90 | 320 / 8 | $6.361,31 | 307 / 12 | $5.577,92 | 306 / 18 |
| Other Circulatory System Diagnoses W Mcc | 37 | 79 / 15 | $36.725,70 | 391 / 12 | $12.284,80 | 693 / 32 | $11.567,90 | 691 / 42 |
| Other Circulatory System O.R. Procedures | 19 | 36 / 4 | $61.947,90 | 165 / 5 | $18.925,40 | 231 / 15 | $17.836,90 | 231 / 15 |
| Other Digestive System Diagnoses W Cc | 24 | 73 / 22 | $28.169,30 | 806 / 40 | $6.815,12 | 873 / 43 | $6.027,88 | 869 / 56 |
| Other Disorders Of Nervous System W Cc | 25 | 31 / 5 | $32.459,40 | 411 / 22 | $6.232,48 | 335 / 16 | $5.465,56 | 335 / 21 |
| Other Kidney & Urinary Tract Diagnoses W Cc | 11 | 92 / 23 | $22.006,80 | 305 / 11 | $6.600,64 | 475 / 25 | $6.135,82 | 475 / 34 |
| Other Kidney & Urinary Tract Diagnoses W Mcc | 15 | 86 / 33 | $29.837,20 | 379 / 17 | $9.368,60 | 379 / 20 | $8.680,53 | 379 / 23 |
| Other Resp System O.R. Procedures W Cc | 11 | 36 / 10 | $48.547,40 | 150 / 5 | $13.115,20 | 130 / 7 | $11.122,20 | 130 / 6 |
| Other Resp System O.R. Procedures W Mcc | 19 | 44 / 9 | $91.424,00 | 294 / 9 | $23.431,30 | 161 / 12 | $20.080,70 | 161 / 6 |
| Other Skin, Subcut Tiss & Breast Proc W Mcc | 11 | 11 / 3 | $43.755,80 | 7 / 1 | $14.093,50 | 8 / 1 | $13.456,30 | 8 / 1 |
| Other Vascular Procedures W Cc | 16 | 86 / 27 | $59.007,80 | 345 / 8 | $16.201,40 | 583 / 18 | $15.439,70 | 580 / 30 |
| Other Vascular Procedures W Mcc | 47 | 50 / 4 | $66.346,80 | 220 / 4 | $20.025,40 | 334 / 12 | $19.069,10 | 332 / 15 |
| Perc Cardiovasc Proc W Drug-Eluting Stent W/O Mcc | 37 | 159 / 32 | $46.196,30 | 157 / 2 | $13.271,90 | 931 / 22 | $12.165,80 | 924 / 58 |
| Perc Cardiovasc Proc W Non-Drug-Eluting Stent W/O Mcc | 19 | 50 / 11 | $52.792,00 | 185 / 3 | $11.972,80 | 359 / 12 | $10.981,90 | 358 / 23 |
| Peripheral Vascular Disorders W Cc | 32 | 52 / 14 | $23.782,00 | 580 / 32 | $7.072,84 | 637 / 53 | $5.650,88 | 634 / 49 |
| Peripheral Vascular Disorders W Mcc | 14 | 35 / 15 | $29.328,60 | 185 / 7 | $8.840,07 | 219 / 13 | $7.822,79 | 219 / 16 |
| Peripheral Vascular Disorders W/O Cc/Mcc | 20 | 25 / 6 | $16.468,80 | 155 / 7 | $4.862,65 | 226 / 12 | $3.915,80 | 226 / 16 |
| Permanent Cardiac Pacemaker Implant W Cc | 13 | 64 / 21 | $58.855,30 | 328 / 11 | $16.556,80 | 463 / 17 | $15.651,40 | 462 / 30 |
| Postoperative & Post-Traumatic Infections W/O Mcc | 12 | 42 / 10 | $25.705,20 | 216 / 6 | $6.319,08 | 206 / 3 | $5.956,58 | 206 / 10 |
| Psychoses | 272 | 75 / 8 | $18.594,80 | 293 / 21 | $7.074,86 | 309 / 17 | $6.028,26 | 309 / 17 |
| Pulmonary Edema & Respiratory Failure | 47 | 156 / 29 | $30.468,80 | 1065 / 33 | $8.347,49 | 1297 / 52 | $7.409,21 | 1294 / 61 |
| Pulmonary Embolism W/O Mcc | 30 | 44 / 10 | $32.560,90 | 905 / 37 | $6.884,97 | 859 / 35 | $5.983,80 | 856 / 51 |
| Red Blood Cell Disorders W Mcc | 25 | 46 / 13 | $30.925,40 | 477 / 23 | $8.489,16 | 642 / 40 | $7.973,36 | 638 / 47 |
| Red Blood Cell Disorders W/O Mcc | 61 | 82 / 10 | $24.112,40 | 1194 / 61 | $5.776,02 | 1320 / 62 | $5.040,43 | 1311 / 74 |
| Renal Failure W Cc | 98 | 123 / 22 | $26.225,80 | 1505 / 68 | $6.653,64 | 1480 / 64 | $5.720,65 | 1471 / 70 |
| Renal Failure W Mcc | 79 | 116 / 15 | $40.939,70 | 1314 / 64 | $10.420,40 | 1327 / 59 | $9.732,49 | 1327 / 69 |
| Renal Failure W/O Cc/Mcc | 11 | 45 / 15 | $16.080,50 | 416 / 11 | $4.607,55 | 573 / 21 | $3.806,36 | 572 / 23 |
| Respiratory Infections & Inflammations W Cc | 17 | 71 / 25 | $43.840,40 | 1037 / 53 | $8.774,41 | 744 / 34 | $7.838,00 | 739 / 41 |
| Respiratory Infections & Inflammations W Mcc | 17 | 119 / 47 | $47.543,50 | 1013 / 36 | $12.880,30 | 1128 / 55 | $12.184,30 | 1114 / 62 |
| Respiratory Neoplasms W Cc | 15 | 32 / 12 | $30.480,70 | 203 / 9 | $8.040,00 | 228 / 18 | $6.960,00 | 227 / 20 |
| Respiratory Neoplasms W Mcc | 15 | 37 / 15 | $37.467,10 | 215 / 7 | $11.268,60 | 325 / 20 | $10.404,50 | 324 / 26 |
| Respiratory System Diagnosis W Ventilator Support <96 Hours | 29 | 102 / 27 | $67.002,90 | 1082 / 52 | $15.675,10 | 1175 / 52 | $14.956,20 | 1162 / 66 |
| Respiratory System Diagnosis W Ventilator Support 96+ Hours | 11 | 60 / 16 | $122.425,00 | 394 / 19 | $34.211,00 | 557 / 22 | $33.700,80 | 556 / 29 |
| Revision Of Hip Or Knee Replacement W/O Cc/Mcc | 12 | 57 / 12 | $71.088,20 | 267 / 11 | $16.811,80 | 234 / 7 | $15.139,20 | 233 / 9 |
| Seizures W Mcc | 16 | 50 / 16 | $37.096,90 | 306 / 12 | $9.723,25 | 313 / 12 | $8.984,31 | 313 / 17 |
| Seizures W/O Mcc | 33 | 75 / 14 | $22.013,40 | 647 / 32 | $5.405,00 | 646 / 36 | $4.381,42 | 643 / 45 |
| Septicemia Or Severe Sepsis W Mv 96+ Hours | 14 | 78 / 19 | $107.371,00 | 235 / 13 | $36.054,90 | 416 / 18 | $35.306,60 | 415 / 24 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W Mcc | 128 | 388 / 57 | $49.642,90 | 1772 / 62 | $12.128,60 | 1684 / 51 | $11.407,50 | 1652 / 68 |
| Septicemia Or Severe Sepsis W/O Mv 96+ Hours W/O Mcc | 36 | 171 / 46 | $28.549,20 | 1529 / 46 | $7.383,14 | 1501 / 61 | $6.261,78 | 1495 / 72 |
| Signs & Symptoms W/O Mcc | 15 | 76 / 24 | $17.495,40 | 509 / 15 | $4.896,93 | 800 / 32 | $4.295,67 | 797 / 42 |
| Simple Pneumonia & Pleurisy W Cc | 67 | 136 / 35 | $26.807,70 | 1758 / 68 | $6.881,40 | 1715 / 63 | $5.740,16 | 1707 / 78 |
| Simple Pneumonia & Pleurisy W Mcc | 61 | 144 / 34 | $38.436,20 | 1502 / 48 | $9.837,85 | 1467 / 63 | $8.618,51 | 1467 / 67 |
| Simple Pneumonia & Pleurisy W/O Cc/Mcc | 19 | 74 / 30 | $19.029,50 | 1123 / 50 | $5.945,74 | 1145 / 78 | $3.834,79 | 1139 / 71 |
| Spinal Fusion Except Cervical W/O Mcc | 39 | 155 / 23 | $103.552,00 | 769 / 27 | $25.540,10 | 827 / 19 | $24.377,00 | 823 / 39 |
| Syncope & Collapse | 51 | 118 / 21 | $28.519,70 | 1371 / 74 | $5.296,65 | 1250 / 52 | $4.474,31 | 1243 / 70 |
| Transient Ischemia | 69 | 56 / 3 | $28.353,90 | 1124 / 58 | $5.136,85 | 1003 / 47 | $4.045,00 | 998 / 61 |
| Transurethral Procedures W Cc | 11 | 30 / 12 | $30.238,50 | 122 / 5 | $8.609,09 | 229 / 14 | $7.573,91 | 229 / 21 |
| Urinary Stones W/O Esw Lithotripsy W/O Mcc | 11 | 35 / 8 | $21.870,50 | 185 / 6 | $4.942,73 | 111 / 13 | $3.266,64 | 111 / 9 | Total 112 procedures | 4.189 | discharges |
Source: Medicare Provider Utilization and Payment Data: Inpatient for FY2014
Average Covered Charges: The provider's average charge for services covered by Medicare for all discharges in the MS-DRG. These will vary from hospital to hospital because of differences in hospital charge structures.
Average Total Payments: The average total payments to all providers for the MS-DRG including the MSDRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Also included in average total payments are co-payment and deductible amounts that the patient is responsible for and any additional payments by third parties for coordination of benefits.
Average Medicare Payments: The average amount that Medicare pays to the provider for Medicare's share of the MS-DRG. Average Medicare payment amounts include the MS-DRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Medicare payments DO NOT include beneficiary co-payments and deductible amounts nor any additional payments from third parties for coordination of benefits. Note: In general, Medicare FFS claims with dates-of-service or dates-of-discharge on or after April 1, 2013, incurred a 2 percent reduction in Medicare payment. This is in response to mandatory across-the-board reductions in Federal spending, also known as sequestration
Hospital Rank: We have calculated the rank for each procedure within a hospital. The left number is the national ranking, the right one is the state ranking. For discharges, ranking is from highest # of discharges to lower (hospital with highest number of discharges ranks first). For charges and payments, lowest means a higher ranking.