Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC

Facility

$6,671.98

Service Code	MSDRG 192
Min. Negotiated Rate	$3,642.17
Max. Negotiated Rate	$6,671.98
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,656.53
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,671.98
Rate for Payer: Plain Church Group Ministry All Commercial	$3,642.17
Rate for Payer: Three Rivers Preferred All Commercial	$4,756.92

MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC

Facility

$22,816.91

Service Code	MSDRG 286
Min. Negotiated Rate	$12,455.52
Max. Negotiated Rate	$22,816.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$19,344.24
Rate for Payer: Anthem Blue Cross of IN Traditional	$22,816.91
Rate for Payer: Plain Church Group Ministry All Commercial	$12,455.52
Rate for Payer: Three Rivers Preferred All Commercial	$16,267.75

MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC

Facility

$11,233.72

Service Code	MSDRG 287
Min. Negotiated Rate	$6,132.37
Max. Negotiated Rate	$11,233.72
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,523.98
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,233.72
Rate for Payer: Plain Church Group Ministry All Commercial	$6,132.37
Rate for Payer: Three Rivers Preferred All Commercial	$8,009.30

MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC

Facility

$11,028.57

Service Code	MSDRG 433
Min. Negotiated Rate	$6,020.39
Max. Negotiated Rate	$11,028.57
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,350.05
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,028.57
Rate for Payer: Plain Church Group Ministry All Commercial	$6,020.39
Rate for Payer: Three Rivers Preferred All Commercial	$7,863.03

MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC

Facility

$20,196.36

Service Code	MSDRG 432
Min. Negotiated Rate	$11,024.99
Max. Negotiated Rate	$20,196.36
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,122.53
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,196.36
Rate for Payer: Plain Church Group Ministry All Commercial	$11,024.99
Rate for Payer: Three Rivers Preferred All Commercial	$14,399.39

MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC

Facility

$7,180.22

Service Code	MSDRG 434
Min. Negotiated Rate	$3,919.61
Max. Negotiated Rate	$7,180.22
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,087.41
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,180.22
Rate for Payer: Plain Church Group Ministry All Commercial	$3,919.61
Rate for Payer: Three Rivers Preferred All Commercial	$5,119.27

MS-DRG 42.00: COAGULATION DISORDERS

Facility

$15,958.33

Service Code	MSDRG 813
Min. Negotiated Rate	$8,711.49
Max. Negotiated Rate	$15,958.33
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,529.52
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,958.33
Rate for Payer: Plain Church Group Ministry All Commercial	$8,711.49
Rate for Payer: Three Rivers Preferred All Commercial	$11,377.80

MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC

Facility

$85,983.25

Service Code	MSDRG 429
Min. Negotiated Rate	$46,937.39
Max. Negotiated Rate	$85,983.25
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$72,896.84
Rate for Payer: Anthem Blue Cross of IN Traditional	$85,983.25
Rate for Payer: Plain Church Group Ministry All Commercial	$46,937.39
Rate for Payer: Three Rivers Preferred All Commercial	$61,303.41

MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC

Facility

$56,395.38

Service Code	MSDRG 430
Min. Negotiated Rate	$30,785.68
Max. Negotiated Rate	$56,395.38
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$47,812.17
Rate for Payer: Anthem Blue Cross of IN Traditional	$56,395.38
Rate for Payer: Plain Church Group Ministry All Commercial	$30,785.68
Rate for Payer: Three Rivers Preferred All Commercial	$40,208.18

MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC

Facility

$11,227.53

Service Code	MSDRG 381
Min. Negotiated Rate	$6,129.00
Max. Negotiated Rate	$11,227.53
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,518.73
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,227.53
Rate for Payer: Plain Church Group Ministry All Commercial	$6,129.00
Rate for Payer: Three Rivers Preferred All Commercial	$8,004.89

MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC

Facility

$19,837.61

Service Code	MSDRG 380
Min. Negotiated Rate	$10,829.15
Max. Negotiated Rate	$19,837.61
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,818.38
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,837.61
Rate for Payer: Plain Church Group Ministry All Commercial	$10,829.15
Rate for Payer: Three Rivers Preferred All Commercial	$14,143.60

MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC

Facility

$7,724.53

Service Code	MSDRG 382
Min. Negotiated Rate	$4,216.75
Max. Negotiated Rate	$7,724.53
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,548.88
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,724.53
Rate for Payer: Plain Church Group Ministry All Commercial	$4,216.75
Rate for Payer: Three Rivers Preferred All Commercial	$5,507.35

MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC

Facility

$10,472.91

Service Code	MSDRG 920
Min. Negotiated Rate	$5,717.06
Max. Negotiated Rate	$10,472.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,878.97
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,472.91
Rate for Payer: Plain Church Group Ministry All Commercial	$5,717.06
Rate for Payer: Three Rivers Preferred All Commercial	$7,466.86

MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC

Facility

$18,799.49

Service Code	MSDRG 919
Min. Negotiated Rate	$10,262.45
Max. Negotiated Rate	$18,799.49
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,938.26
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,799.49
Rate for Payer: Plain Church Group Ministry All Commercial	$10,262.45
Rate for Payer: Three Rivers Preferred All Commercial	$13,403.46

MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC

Facility

$7,089.50

Service Code	MSDRG 921
Min. Negotiated Rate	$3,870.09
Max. Negotiated Rate	$7,089.50
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,010.50
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,089.50
Rate for Payer: Plain Church Group Ministry All Commercial	$3,870.09
Rate for Payer: Three Rivers Preferred All Commercial	$5,054.60

MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES

Facility

$112,305.22

Service Code	MSDRG 212
Min. Negotiated Rate	$61,306.29
Max. Negotiated Rate	$112,305.22
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$95,212.69
Rate for Payer: Anthem Blue Cross of IN Traditional	$112,305.22
Rate for Payer: Plain Church Group Ministry All Commercial	$61,306.29
Rate for Payer: Three Rivers Preferred All Commercial	$80,070.16

MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION

Facility

$63,775.60

Service Code	MSDRG 317
Min. Negotiated Rate	$34,814.46
Max. Negotiated Rate	$63,775.60
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$54,069.14
Rate for Payer: Anthem Blue Cross of IN Traditional	$63,775.60
Rate for Payer: Plain Church Group Ministry All Commercial	$34,814.46
Rate for Payer: Three Rivers Preferred All Commercial	$45,470.04

MS-DRG 42.00: CONCUSSION WITH CC

Facility

$11,052.28

Service Code	MSDRG 089
Min. Negotiated Rate	$6,033.33
Max. Negotiated Rate	$11,052.28
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,370.15
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,052.28
Rate for Payer: Plain Church Group Ministry All Commercial	$6,033.33
Rate for Payer: Three Rivers Preferred All Commercial	$7,879.94

MS-DRG 42.00: CONCUSSION WITH MCC

Facility

$14,542.91

Service Code	MSDRG 088
Min. Negotiated Rate	$7,938.83
Max. Negotiated Rate	$14,542.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,329.52
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,542.91
Rate for Payer: Plain Church Group Ministry All Commercial	$7,938.83
Rate for Payer: Three Rivers Preferred All Commercial	$10,368.65

MS-DRG 42.00: CONCUSSION WITHOUT CC/MCC

Facility

$8,837.91

Service Code	MSDRG 090
Min. Negotiated Rate	$4,824.52
Max. Negotiated Rate	$8,837.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,492.80
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,837.91
Rate for Payer: Plain Church Group Ministry All Commercial	$4,824.52
Rate for Payer: Three Rivers Preferred All Commercial	$6,301.15

MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH CC

Facility

$11,934.73

Service Code	MSDRG 546
Min. Negotiated Rate	$6,515.05
Max. Negotiated Rate	$11,934.73
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,118.30
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,934.73
Rate for Payer: Plain Church Group Ministry All Commercial	$6,515.05
Rate for Payer: Three Rivers Preferred All Commercial	$8,509.09

MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH MCC

Facility

$26,049.81

Service Code	MSDRG 545
Min. Negotiated Rate	$14,220.33
Max. Negotiated Rate	$26,049.81
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$22,085.11
Rate for Payer: Anthem Blue Cross of IN Traditional	$26,049.81
Rate for Payer: Plain Church Group Ministry All Commercial	$14,220.33
Rate for Payer: Three Rivers Preferred All Commercial	$18,572.72

MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC

Facility

$7,692.58

Service Code	MSDRG 547
Min. Negotiated Rate	$4,199.30
Max. Negotiated Rate	$7,692.58
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,521.79
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,692.58
Rate for Payer: Plain Church Group Ministry All Commercial	$4,199.30
Rate for Payer: Three Rivers Preferred All Commercial	$5,484.57

MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC

Facility

$80,579.27

Service Code	MSDRG 233
Min. Negotiated Rate	$43,987.42
Max. Negotiated Rate	$80,579.27
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$68,315.34
Rate for Payer: Anthem Blue Cross of IN Traditional	$80,579.27
Rate for Payer: Plain Church Group Ministry All Commercial	$43,987.42
Rate for Payer: Three Rivers Preferred All Commercial	$57,450.54

MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC

Facility

$54,845.94

Service Code	MSDRG 234
Min. Negotiated Rate	$29,939.85
Max. Negotiated Rate	$54,845.94
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$46,498.55
Rate for Payer: Anthem Blue Cross of IN Traditional	$54,845.94
Rate for Payer: Plain Church Group Ministry All Commercial	$29,939.85
Rate for Payer: Three Rivers Preferred All Commercial	$39,103.47

Know your out-of-pocket cost for care.

All Charges