Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: ACUTE LEUKEMIA WITH MCC

Facility

$56,980.94

Service Code	MSDRG 834
Min. Negotiated Rate	$31,105.32
Max. Negotiated Rate	$56,980.94
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$48,308.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$56,980.94
Rate for Payer: Plain Church Group Ministry All Commercial	$31,105.32
Rate for Payer: Three Rivers Preferred All Commercial	$40,625.65

MS-DRG 42.00: ACUTE LEUKEMIA WITH OTHER PROCEDURES

Facility

$94,965.48

Service Code	MSDRG 850
Min. Negotiated Rate	$51,840.70
Max. Negotiated Rate	$94,965.48
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$80,512.01
Rate for Payer: Anthem Blue Cross of IN Traditional	$94,965.48
Rate for Payer: Plain Church Group Ministry All Commercial	$51,840.70
Rate for Payer: Three Rivers Preferred All Commercial	$67,707.46

MS-DRG 42.00: ACUTE LEUKEMIA WITHOUT CC/MCC

Facility

$13,099.65

Service Code	MSDRG 836
Min. Negotiated Rate	$7,150.97
Max. Negotiated Rate	$13,099.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,105.92
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,099.65
Rate for Payer: Plain Church Group Ministry All Commercial	$7,150.97
Rate for Payer: Three Rivers Preferred All Commercial	$9,339.65

MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$11,991.43

Service Code	MSDRG 121
Min. Negotiated Rate	$6,546.00
Max. Negotiated Rate	$11,991.43
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,166.37
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,991.43
Rate for Payer: Plain Church Group Ministry All Commercial	$6,546.00
Rate for Payer: Three Rivers Preferred All Commercial	$8,549.52

MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$6,992.59

Service Code	MSDRG 122
Min. Negotiated Rate	$3,817.19
Max. Negotiated Rate	$6,992.59
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,928.34
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,992.59
Rate for Payer: Plain Church Group Ministry All Commercial	$3,817.19
Rate for Payer: Three Rivers Preferred All Commercial	$4,985.51

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC

Facility

$9,502.84

Service Code	MSDRG 281
Min. Negotiated Rate	$5,187.50
Max. Negotiated Rate	$9,502.84
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,056.53
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,502.84
Rate for Payer: Plain Church Group Ministry All Commercial	$5,187.50
Rate for Payer: Three Rivers Preferred All Commercial	$6,775.23

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC

Facility

$16,921.19

Service Code	MSDRG 280
Min. Negotiated Rate	$9,237.11
Max. Negotiated Rate	$16,921.19
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,345.84
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,921.19
Rate for Payer: Plain Church Group Ministry All Commercial	$9,237.11
Rate for Payer: Three Rivers Preferred All Commercial	$12,064.29

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC

Facility

$7,475.06

Service Code	MSDRG 282
Min. Negotiated Rate	$4,080.56
Max. Negotiated Rate	$7,475.06
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,337.37
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,475.06
Rate for Payer: Plain Church Group Ministry All Commercial	$4,080.56
Rate for Payer: Three Rivers Preferred All Commercial	$5,329.48

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC

Facility

$7,638.97

Service Code	MSDRG 284
Min. Negotiated Rate	$4,170.04
Max. Negotiated Rate	$7,638.97
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,476.34
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,638.97
Rate for Payer: Plain Church Group Ministry All Commercial	$4,170.04
Rate for Payer: Three Rivers Preferred All Commercial	$5,446.35

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC

Facility

$20,158.22

Service Code	MSDRG 283
Min. Negotiated Rate	$11,004.17
Max. Negotiated Rate	$20,158.22
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,090.20
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,158.22
Rate for Payer: Plain Church Group Ministry All Commercial	$11,004.17
Rate for Payer: Three Rivers Preferred All Commercial	$14,372.19

MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC

Facility

$5,787.47

Service Code	MSDRG 285
Min. Negotiated Rate	$3,159.32
Max. Negotiated Rate	$5,787.47
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$4,906.64
Rate for Payer: Anthem Blue Cross of IN Traditional	$5,787.47
Rate for Payer: Plain Church Group Ministry All Commercial	$3,159.32
Rate for Payer: Three Rivers Preferred All Commercial	$4,126.29

MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC

Facility

$23,494.21

Service Code	MSDRG 614
Min. Negotiated Rate	$12,825.25
Max. Negotiated Rate	$23,494.21
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$19,918.46
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,494.21
Rate for Payer: Plain Church Group Ministry All Commercial	$12,825.25
Rate for Payer: Three Rivers Preferred All Commercial	$16,750.65

MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC

Facility

$14,772.80

Service Code	MSDRG 615
Min. Negotiated Rate	$8,064.32
Max. Negotiated Rate	$14,772.80
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,524.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,772.80
Rate for Payer: Plain Church Group Ministry All Commercial	$8,064.32
Rate for Payer: Three Rivers Preferred All Commercial	$10,532.55

MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$11,738.86

Service Code	MSDRG 560
Min. Negotiated Rate	$6,408.13
Max. Negotiated Rate	$11,738.86
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,952.24
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,738.86
Rate for Payer: Plain Church Group Ministry All Commercial	$6,408.13
Rate for Payer: Three Rivers Preferred All Commercial	$8,369.44

MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$19,136.60

Service Code	MSDRG 559
Min. Negotiated Rate	$10,446.48
Max. Negotiated Rate	$19,136.60
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,224.06
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,136.60
Rate for Payer: Plain Church Group Ministry All Commercial	$10,446.48
Rate for Payer: Three Rivers Preferred All Commercial	$13,643.81

MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC

Facility

$8,428.64

Service Code	MSDRG 561
Min. Negotiated Rate	$4,601.11
Max. Negotiated Rate	$8,428.64
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,145.82
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,428.64
Rate for Payer: Plain Church Group Ministry All Commercial	$4,601.11
Rate for Payer: Three Rivers Preferred All Commercial	$6,009.36

MS-DRG 42.00: AFTERCARE WITH CC/MCC

Facility

$11,123.41

Service Code	MSDRG 949
Min. Negotiated Rate	$6,072.16
Max. Negotiated Rate	$11,123.41
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,430.46
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,123.41
Rate for Payer: Plain Church Group Ministry All Commercial	$6,072.16
Rate for Payer: Three Rivers Preferred All Commercial	$7,930.65

MS-DRG 42.00: AFTERCARE WITHOUT CC/MCC

Facility

$6,042.10

Service Code	MSDRG 950
Min. Negotiated Rate	$3,298.32
Max. Negotiated Rate	$6,042.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,122.51
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,042.10
Rate for Payer: Plain Church Group Ministry All Commercial	$3,298.32
Rate for Payer: Three Rivers Preferred All Commercial	$4,307.84

MS-DRG 42.00: AICD GENERATOR PROCEDURES

Facility

$50,378.02

Service Code	MSDRG 245
Min. Negotiated Rate	$27,500.86
Max. Negotiated Rate	$50,378.02
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$42,710.63
Rate for Payer: Anthem Blue Cross of IN Traditional	$50,378.02
Rate for Payer: Plain Church Group Ministry All Commercial	$27,500.86
Rate for Payer: Three Rivers Preferred All Commercial	$35,917.98

MS-DRG 42.00: AICD LEAD PROCEDURES

Facility

$36,774.26

Service Code	MSDRG 265
Min. Negotiated Rate	$20,074.70
Max. Negotiated Rate	$36,774.26
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$31,177.33
Rate for Payer: Anthem Blue Cross of IN Traditional	$36,774.26
Rate for Payer: Plain Church Group Ministry All Commercial	$20,074.70
Rate for Payer: Three Rivers Preferred All Commercial	$26,218.92

MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA

Facility

$6,433.85

Service Code	MSDRG 894
Min. Negotiated Rate	$3,512.17
Max. Negotiated Rate	$6,433.85
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,454.63
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,433.85
Rate for Payer: Plain Church Group Ministry All Commercial	$3,512.17
Rate for Payer: Three Rivers Preferred All Commercial	$4,587.14

MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC

Facility

$18,358.27

Service Code	MSDRG 896
Min. Negotiated Rate	$10,021.59
Max. Negotiated Rate	$18,358.27
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,564.19
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,358.27
Rate for Payer: Plain Church Group Ministry All Commercial	$10,021.59
Rate for Payer: Three Rivers Preferred All Commercial	$13,088.88

MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC

Facility

$9,094.60

Service Code	MSDRG 897
Min. Negotiated Rate	$4,964.65
Max. Negotiated Rate	$9,094.60
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,710.43
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,094.60
Rate for Payer: Plain Church Group Ministry All Commercial	$4,964.65
Rate for Payer: Three Rivers Preferred All Commercial	$6,484.17

MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY

Facility

$14,926.40

Service Code	MSDRG 895
Min. Negotiated Rate	$8,148.17
Max. Negotiated Rate	$14,926.40
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,654.65
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,926.40
Rate for Payer: Plain Church Group Ministry All Commercial	$8,148.17
Rate for Payer: Three Rivers Preferred All Commercial	$10,642.07

MS-DRG 42.00: ALLERGIC REACTIONS WITH MCC

Facility

$17,916.01

Service Code	MSDRG 915
Min. Negotiated Rate	$9,780.17
Max. Negotiated Rate	$17,916.01
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,189.25
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,916.01
Rate for Payer: Plain Church Group Ministry All Commercial	$9,780.17
Rate for Payer: Three Rivers Preferred All Commercial	$12,773.57

Know your out-of-pocket cost for care.

All Charges