Executive Summary
Key billing findings across medical conditions, admission types, and insurance providers.
Across 4,991 hospital admissions, Asthma generated the highest average billing at $25,755. Urgent admissions carried the highest average cost at $25,323, while Blue Cross was the insurer associated with the highest average billed amount at $25,754. IQR-based anomaly detection (multiplier = 1.5) flagged 0 admissions (0%) as billing outliers.
Billing by Medical Condition
Average billing amount by medical condition (top 8 conditions).
Asthma is the most expensive condition with an average bill of $25,755, while Hypertension has the lowest average at $24,555. The spread between the highest and lowest-cost conditions is $1,200, indicating substantial variation in treatment costs across diagnoses. Condition-specific cost management strategies could yield significant savings.
Cost by Admission Type
Average billing amount by admission type.
Urgent admissions carry the highest average cost at $25,323, compared to $25,281 for Emergency admissions. The billing premium between the most and least expensive admission type is $43. These cost differentials likely reflect differences in care intensity, staffing requirements, and resource utilization across admission categories.
Insurance Provider Billing Patterns
Average billing amount per insurance provider.
Blue Cross is associated with the highest average billed amount at $25,754, versus $24,678 for Medicare. The billing spread across insurers is $1,076. Variation across insurers may reflect negotiated contract rates, patient case-mix differences, or utilization patterns tied to plan types.
Length of Stay vs Billing Amount
Scatter of billing amount by length of stay (days), colored by admission type.
The Pearson correlation between length of stay and billing amount is 0.002 (weak relationship). Longer stays accumulate more charges across room, nursing, and ancillary services. Emergency admissions may show steeper per-day costs due to intensive initial care, while Elective admissions typically have more predictable, planned cost structures.
Patient Age vs Billing Amount
Scatter of billing amount by patient age, colored by medical condition.
Age and billing amount have a correlation of 0.0056. Older patients may incur higher bills due to complex comorbidities and longer recovery times. Analyzing cost by condition across age groups identifies high-cost demographic segments that may benefit from targeted care management programs.
Billing Amount Distribution
Frequency histogram of total billing amounts across all admissions.
The billing distribution is approximately symmetric (skewness = 0.047). The middle 50% of charges falls between $13,345 and $37,169. The mean bill is $25,302 while the median is $25,008. High-end outliers pull the mean above the median, confirming the skew direction.
Billing Anomalies
Admissions with extreme billing amounts flagged via Z-score threshold (|z| > 2; IQR method found no outliers at current multiplier).
| age | admission_type | billing_amount | medical_condition | insurance_provider |
|---|---|---|---|---|
| 74 | Urgent | 5.237e+04 | Cancer | UnitedHealthcare |
| 18 | Urgent | 5.221e+04 | Diabetes | Aetna |
| 21 | Elective | 5.202e+04 | Obesity | Cigna |
| 41 | Elective | 5.163e+04 | Asthma | Blue Cross |
| 58 | Emergency | 5.131e+04 | Obesity | Blue Cross |
| 51 | Elective | 5.109e+04 | Cancer | Medicare |
| 76 | Urgent | 5.108e+04 | Cancer | Aetna |
| 63 | Urgent | 5.104e+04 | Arthritis | UnitedHealthcare |
| 78 | Emergency | 5.094e+04 | Cancer | Medicare |
| 43 | Urgent | 5.088e+04 | Arthritis | Blue Cross |
| 30 | Emergency | 5.083e+04 | Hypertension | Medicare |
| 38 | Urgent | 5.082e+04 | Hypertension | Blue Cross |
| 58 | Elective | 5.081e+04 | Arthritis | Blue Cross |
| 44 | Elective | 5.078e+04 | Diabetes | UnitedHealthcare |
| 33 | Urgent | 5.076e+04 | Cancer | Cigna |
| 71 | Urgent | 5.074e+04 | Hypertension | Aetna |
| 29 | Emergency | 5.068e+04 | Asthma | Blue Cross |
| 54 | Urgent | 5.065e+04 | Cancer | Blue Cross |
| 37 | Urgent | 5.063e+04 | Diabetes | Aetna |
| 27 | Urgent | 5.057e+04 | Asthma | Aetna |
| 31 | Urgent | 5.056e+04 | Cancer | Cigna |
| 32 | Urgent | 5.053e+04 | Cancer | Aetna |
| 46 | Emergency | 5.051e+04 | Hypertension | Medicare |
| 64 | Urgent | 5.05e+04 | Diabetes | UnitedHealthcare |
| 73 | Urgent | 5.041e+04 | Diabetes | Medicare |
| 66 | Elective | 5.04e+04 | Arthritis | Cigna |
| 31 | Emergency | 5.039e+04 | Hypertension | Cigna |
| 62 | Elective | 5.036e+04 | Hypertension | Aetna |
| 53 | Elective | 5.034e+04 | Asthma | UnitedHealthcare |
| 51 | Elective | 5.034e+04 | Asthma | UnitedHealthcare |
| 49 | Urgent | 5.033e+04 | Hypertension | UnitedHealthcare |
| 65 | Elective | 5.031e+04 | Obesity | Aetna |
| 71 | Urgent | 5.028e+04 | Diabetes | Blue Cross |
| 46 | Elective | 5.026e+04 | Obesity | Cigna |
| 55 | Urgent | 5.025e+04 | Obesity | Cigna |
| 28 | Urgent | 5.021e+04 | Diabetes | UnitedHealthcare |
| 27 | Urgent | 5.02e+04 | Asthma | Blue Cross |
| 29 | Elective | 5.017e+04 | Arthritis | Medicare |
| 71 | Urgent | 5.014e+04 | Cancer | Blue Cross |
| 41 | Elective | 5.013e+04 | Arthritis | Aetna |
| 66 | Elective | 5.012e+04 | Diabetes | Cigna |
| 63 | Urgent | 5.009e+04 | Cancer | Medicare |
| 54 | Urgent | 5.008e+04 | Hypertension | Medicare |
| 73 | Emergency | 5.007e+04 | Cancer | Cigna |
| 69 | Elective | 5.007e+04 | Obesity | Aetna |
| 34 | Emergency | 5.004e+04 | Diabetes | UnitedHealthcare |
| 32 | Emergency | 5e+04 | Asthma | Cigna |
| 65 | Elective | 4.995e+04 | Diabetes | Blue Cross |
| 38 | Elective | 4.995e+04 | Arthritis | Aetna |
| 53 | Emergency | 4.995e+04 | Asthma | Medicare |
| 22 | Emergency | 1465 | Hypertension | Aetna |
| 20 | Elective | 1463 | Arthritis | Cigna |
| 80 | Emergency | 1459 | Cancer | UnitedHealthcare |
| 78 | Urgent | 1455 | Cancer | Blue Cross |
| 65 | Elective | 1421 | Cancer | Aetna |
| 26 | Emergency | 1419 | Hypertension | Blue Cross |
| 31 | Urgent | 1403 | Asthma | UnitedHealthcare |
| 42 | Emergency | 1399 | Diabetes | Aetna |
| 71 | Urgent | 1389 | Hypertension | Cigna |
| 47 | Elective | 1371 | Asthma | Medicare |
| 71 | Emergency | 1348 | Hypertension | Medicare |
| 48 | Urgent | 1345 | Hypertension | Cigna |
| 42 | Urgent | 1303 | Asthma | Medicare |
| 31 | Urgent | 1266 | Hypertension | Cigna |
| 28 | Elective | 1209 | Arthritis | Medicare |
| 47 | Elective | 1168 | Obesity | UnitedHealthcare |
| 68 | Emergency | 1120 | Arthritis | UnitedHealthcare |
| 47 | Emergency | 1118 | Arthritis | Medicare |
| 49 | Elective | 1093 | Hypertension | Cigna |
| 46 | Urgent | 1089 | Obesity | UnitedHealthcare |
| 26 | Emergency | 1082 | Diabetes | Aetna |
| 75 | Urgent | 1074 | Hypertension | Medicare |
| 58 | Elective | 1027 | Arthritis | Cigna |
| 64 | Urgent | 1000 | Arthritis | UnitedHealthcare |
| 64 | Elective | 967.3 | Arthritis | UnitedHealthcare |
| 68 | Emergency | 940.7 | Arthritis | UnitedHealthcare |
| 61 | Urgent | 935.5 | Obesity | Medicare |
| 34 | Elective | 929.9 | Cancer | Medicare |
| 57 | Elective | 900 | Hypertension | UnitedHealthcare |
| 71 | Urgent | 895.3 | Asthma | Cigna |
| 21 | Emergency | 870.3 | Obesity | UnitedHealthcare |
| 34 | Urgent | 856.6 | Arthritis | Blue Cross |
| 81 | Elective | 850 | Obesity | Blue Cross |
| 28 | Emergency | 846.7 | Diabetes | Aetna |
| 82 | Urgent | 843.1 | Arthritis | Blue Cross |
| 61 | Elective | 830 | Arthritis | Cigna |
| 26 | Elective | 738.6 | Obesity | Cigna |
| 55 | Urgent | 651.9 | Hypertension | Cigna |
| 67 | Elective | 584.8 | Asthma | Medicare |
| 55 | Emergency | 574.5 | Asthma | Blue Cross |
| 25 | Elective | 552.5 | Asthma | Medicare |
| 60 | Elective | 539.5 | Diabetes | UnitedHealthcare |
| 36 | Elective | 480.1 | Asthma | Aetna |
| 62 | Emergency | 436.3 | Diabetes | Blue Cross |
| 54 | Elective | 314.1 | Cancer | Aetna |
| 73 | Elective | 280.4 | Hypertension | Cigna |
| 71 | Urgent | 238.8 | Arthritis | UnitedHealthcare |
| 80 | Emergency | 236.1 | Asthma | UnitedHealthcare |
| 65 | Urgent | 162.2 | Hypertension | Medicare |
| 25 | Emergency | 53.26 | Diabetes | Cigna |
100 admissions (2% of total) were flagged as billing outliers using Z-score threshold (|z| > 2; IQR method found no outliers at current multiplier). The highest anomalous bill was $52,373. Hypertension is the most over-represented condition among anomalies, warranting clinical audit to verify billing accuracy and coding compliance.