Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: ALLERGIC REACTIONS WITHOUT MCC

Facility

$6,846.21

Service Code	MSDRG 916
Min. Negotiated Rate	$3,737.28
Max. Negotiated Rate	$6,846.21
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,804.23
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,846.21
Rate for Payer: Plain Church Group Ministry All Commercial	$3,737.28
Rate for Payer: Three Rivers Preferred All Commercial	$4,881.14

MS-DRG 42.00: ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$135,066.46

Service Code	MSDRG 014
Min. Negotiated Rate	$73,731.43
Max. Negotiated Rate	$135,066.46
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$114,509.73
Rate for Payer: Anthem Blue Cross of IN Traditional	$135,066.46
Rate for Payer: Plain Church Group Ministry All Commercial	$73,731.43
Rate for Payer: Three Rivers Preferred All Commercial	$96,298.23

MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC

Facility

$30,021.87

Service Code	MSDRG 240
Min. Negotiated Rate	$16,388.64
Max. Negotiated Rate	$30,021.87
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$25,452.63
Rate for Payer: Anthem Blue Cross of IN Traditional	$30,021.87
Rate for Payer: Plain Church Group Ministry All Commercial	$16,388.64
Rate for Payer: Three Rivers Preferred All Commercial	$21,404.67

MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC

Facility

$51,925.40

Service Code	MSDRG 239
Min. Negotiated Rate	$28,345.56
Max. Negotiated Rate	$51,925.40
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$44,022.51
Rate for Payer: Anthem Blue Cross of IN Traditional	$51,925.40
Rate for Payer: Plain Church Group Ministry All Commercial	$28,345.56
Rate for Payer: Three Rivers Preferred All Commercial	$37,021.21

MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC

Facility

$15,565.56

Service Code	MSDRG 241
Min. Negotiated Rate	$8,497.08
Max. Negotiated Rate	$15,565.56
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,196.53
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,565.56
Rate for Payer: Plain Church Group Ministry All Commercial	$8,497.08
Rate for Payer: Three Rivers Preferred All Commercial	$11,097.76

MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC

Facility

$22,239.61

Service Code	MSDRG 475
Min. Negotiated Rate	$12,140.38
Max. Negotiated Rate	$22,239.61
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$18,854.80
Rate for Payer: Anthem Blue Cross of IN Traditional	$22,239.61
Rate for Payer: Plain Church Group Ministry All Commercial	$12,140.38
Rate for Payer: Three Rivers Preferred All Commercial	$15,856.16

MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC

Facility

$46,232.77

Service Code	MSDRG 474
Min. Negotiated Rate	$25,238.01
Max. Negotiated Rate	$46,232.77
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$39,196.28
Rate for Payer: Anthem Blue Cross of IN Traditional	$46,232.77
Rate for Payer: Plain Church Group Ministry All Commercial	$25,238.01
Rate for Payer: Three Rivers Preferred All Commercial	$32,962.54

MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC

Facility

$11,990.40

Service Code	MSDRG 476
Min. Negotiated Rate	$6,545.44
Max. Negotiated Rate	$11,990.40
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,165.49
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,990.40
Rate for Payer: Plain Church Group Ministry All Commercial	$6,545.44
Rate for Payer: Three Rivers Preferred All Commercial	$8,548.78

MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC

Facility

$19,912.86

Service Code	MSDRG 617
Min. Negotiated Rate	$10,870.23
Max. Negotiated Rate	$19,912.86
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,882.18
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,912.86
Rate for Payer: Plain Church Group Ministry All Commercial	$10,870.23
Rate for Payer: Three Rivers Preferred All Commercial	$14,197.26

MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC

Facility

$39,844.29

Service Code	MSDRG 616
Min. Negotiated Rate	$21,750.60
Max. Negotiated Rate	$39,844.29
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$33,780.10
Rate for Payer: Anthem Blue Cross of IN Traditional	$39,844.29
Rate for Payer: Plain Church Group Ministry All Commercial	$21,750.60
Rate for Payer: Three Rivers Preferred All Commercial	$28,407.75

MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC

Facility

$12,835.74

Service Code	MSDRG 618
Min. Negotiated Rate	$7,006.90
Max. Negotiated Rate	$12,835.74
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,882.17
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,835.74
Rate for Payer: Plain Church Group Ministry All Commercial	$7,006.90
Rate for Payer: Three Rivers Preferred All Commercial	$9,151.49

MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH CC

Facility

$12,978.00

Service Code	MSDRG 348
Min. Negotiated Rate	$7,084.56
Max. Negotiated Rate	$12,978.00
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,002.79
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,978.00
Rate for Payer: Plain Church Group Ministry All Commercial	$7,084.56
Rate for Payer: Three Rivers Preferred All Commercial	$9,252.92

MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH MCC

Facility

$24,399.34

Service Code	MSDRG 347
Min. Negotiated Rate	$13,319.36
Max. Negotiated Rate	$24,399.34
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$20,685.83
Rate for Payer: Anthem Blue Cross of IN Traditional	$24,399.34
Rate for Payer: Plain Church Group Ministry All Commercial	$13,319.36
Rate for Payer: Three Rivers Preferred All Commercial	$17,395.98

MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC

Facility

$9,081.20

Service Code	MSDRG 349
Min. Negotiated Rate	$4,957.34
Max. Negotiated Rate	$9,081.20
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,699.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,081.20
Rate for Payer: Plain Church Group Ministry All Commercial	$4,957.34
Rate for Payer: Three Rivers Preferred All Commercial	$6,474.61

MS-DRG 42.00: ANGINA PECTORIS

Facility

$7,198.77

Service Code	MSDRG 311
Min. Negotiated Rate	$3,929.74
Max. Negotiated Rate	$7,198.77
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,103.14
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,198.77
Rate for Payer: Plain Church Group Ministry All Commercial	$3,929.74
Rate for Payer: Three Rivers Preferred All Commercial	$5,132.51

MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC

Facility

$68,736.29

Service Code	MSDRG 268
Min. Negotiated Rate	$37,522.45
Max. Negotiated Rate	$68,736.29
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$58,274.82
Rate for Payer: Anthem Blue Cross of IN Traditional	$68,736.29
Rate for Payer: Plain Church Group Ministry All Commercial	$37,522.45
Rate for Payer: Three Rivers Preferred All Commercial	$49,006.86

MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC

Facility

$42,892.66

Service Code	MSDRG 269
Min. Negotiated Rate	$23,414.67
Max. Negotiated Rate	$42,892.66
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$36,364.52
Rate for Payer: Anthem Blue Cross of IN Traditional	$42,892.66
Rate for Payer: Plain Church Group Ministry All Commercial	$23,414.67
Rate for Payer: Three Rivers Preferred All Commercial	$30,581.15

MS-DRG 42.00: APPENDIX PROCEDURES WITH CC

Facility

$15,599.58

Service Code	MSDRG 398
Min. Negotiated Rate	$8,515.65
Max. Negotiated Rate	$15,599.58
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,225.37
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,599.58
Rate for Payer: Plain Church Group Ministry All Commercial	$8,515.65
Rate for Payer: Three Rivers Preferred All Commercial	$11,122.02

MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC

Facility

$25,543.64

Service Code	MSDRG 397
Min. Negotiated Rate	$13,944.02
Max. Negotiated Rate	$25,543.64
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$21,655.97
Rate for Payer: Anthem Blue Cross of IN Traditional	$25,543.64
Rate for Payer: Plain Church Group Ministry All Commercial	$13,944.02
Rate for Payer: Three Rivers Preferred All Commercial	$18,211.83

MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC

Facility

$11,585.25

Service Code	MSDRG 399
Min. Negotiated Rate	$6,324.27
Max. Negotiated Rate	$11,585.25
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,822.01
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,585.25
Rate for Payer: Plain Church Group Ministry All Commercial	$6,324.27
Rate for Payer: Three Rivers Preferred All Commercial	$8,259.93

MS-DRG 42.00: ARTHROSCOPY

Facility

$18,109.82

Service Code	MSDRG 509
Min. Negotiated Rate	$9,885.97
Max. Negotiated Rate	$18,109.82
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,353.56
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,109.82
Rate for Payer: Plain Church Group Ministry All Commercial	$9,885.97
Rate for Payer: Three Rivers Preferred All Commercial	$12,911.75

MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC

Facility

$11,992.46

Service Code	MSDRG 302
Min. Negotiated Rate	$6,546.56
Max. Negotiated Rate	$11,992.46
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,167.24
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,992.46
Rate for Payer: Plain Church Group Ministry All Commercial	$6,546.56
Rate for Payer: Three Rivers Preferred All Commercial	$8,550.25

MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC

Facility

$6,931.77

Service Code	MSDRG 303
Min. Negotiated Rate	$3,783.98
Max. Negotiated Rate	$6,931.77
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,876.78
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,931.77
Rate for Payer: Plain Church Group Ministry All Commercial	$3,783.98
Rate for Payer: Three Rivers Preferred All Commercial	$4,942.14

MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC

Facility

$62,224.09

Service Code	MSDRG 016
Min. Negotiated Rate	$33,967.51
Max. Negotiated Rate	$62,224.09
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$52,753.77
Rate for Payer: Anthem Blue Cross of IN Traditional	$62,224.09
Rate for Payer: Plain Church Group Ministry All Commercial	$33,967.51
Rate for Payer: Three Rivers Preferred All Commercial	$44,363.86

MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC

Facility

$62,224.09

Service Code	MSDRG 017
Min. Negotiated Rate	$33,967.51
Max. Negotiated Rate	$62,224.09
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$52,753.77
Rate for Payer: Anthem Blue Cross of IN Traditional	$62,224.09
Rate for Payer: Plain Church Group Ministry All Commercial	$33,967.51
Rate for Payer: Three Rivers Preferred All Commercial	$44,363.86

Know your out-of-pocket cost for care.

All Charges