Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

PR SIG 3NX MOTION CHARGE & GO MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257CD
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3NX PURE CHARGE & GO BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AZ
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3NX PURE CHARGE & GO MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257CB
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3NX STYLETTO CONNECT BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261BC
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3NX STYLETTOCONNECTMONO

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257CH
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX ACE BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261R
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX ACE BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257R
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX CARAT BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261T
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX CARAT BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257T
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX CELLION BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261Y
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX CELLION BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257Y
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX INSIO CUST CIC HA MON

Professional

$1,000.00

Service Code	CPT V5254
Hospital Charge Code	zV5254F
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX INSIO CUST ITE HA MON

Professional

$1,000.00

Service Code	CPT V5256
Hospital Charge Code	zV5256C
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX INSIO CUSTOM CIC HA BI

Professional

$2,000.00

Service Code	CPT V5258
Hospital Charge Code	zV5258F
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX INSIO CUSTOM ITE HA BI

Professional

$2,000.00

Service Code	CPT V5260
Hospital Charge Code	zV5260C
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX MOTION P BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261W
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX MOTION P BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257W
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX MOTION SA BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261V
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX MOTION SA BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257V
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX MOTION SP BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261X
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX MOTION SP BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257X
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX MOTION SX BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261U
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX MOTION SX BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257U
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR SIG 3PX PURE BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261S
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR SIG 3PX PURE BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257S
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

Price Transparency.

All Charges