Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$60,660.22

Service Code	MSDRG 235
Min. Negotiated Rate	$33,113.81
Max. Negotiated Rate	$60,660.22
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$51,427.91
Rate for Payer: Anthem Blue Cross of IN Traditional	$60,660.22
Rate for Payer: Plain Church Group Ministry All Commercial	$33,113.81
Rate for Payer: Three Rivers Preferred All Commercial	$43,248.87

MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC

Facility

$42,391.64

Service Code	MSDRG 236
Min. Negotiated Rate	$23,141.17
Max. Negotiated Rate	$42,391.64
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$35,939.75
Rate for Payer: Anthem Blue Cross of IN Traditional	$42,391.64
Rate for Payer: Plain Church Group Ministry All Commercial	$23,141.17
Rate for Payer: Three Rivers Preferred All Commercial	$30,223.94

MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITH MCC

Facility

$87,357.44

Service Code	MSDRG 231
Min. Negotiated Rate	$47,687.55
Max. Negotiated Rate	$87,357.44
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$74,061.89
Rate for Payer: Anthem Blue Cross of IN Traditional	$87,357.44
Rate for Payer: Plain Church Group Ministry All Commercial	$47,687.55
Rate for Payer: Three Rivers Preferred All Commercial	$62,283.17

MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITHOUT MCC

Facility

$62,974.59

Service Code	MSDRG 232
Min. Negotiated Rate	$34,377.20
Max. Negotiated Rate	$62,974.59
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$53,390.04
Rate for Payer: Anthem Blue Cross of IN Traditional	$62,974.59
Rate for Payer: Plain Church Group Ministry All Commercial	$34,377.20
Rate for Payer: Three Rivers Preferred All Commercial	$44,898.94

MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC

Facility

$43,910.15

Service Code	MSDRG 323
Min. Negotiated Rate	$23,970.11
Max. Negotiated Rate	$43,910.15
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$37,227.16
Rate for Payer: Anthem Blue Cross of IN Traditional	$43,910.15
Rate for Payer: Plain Church Group Ministry All Commercial	$23,970.11
Rate for Payer: Three Rivers Preferred All Commercial	$31,306.59

MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$32,938.29

Service Code	MSDRG 324
Min. Negotiated Rate	$17,980.68
Max. Negotiated Rate	$32,938.29
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$27,925.17
Rate for Payer: Anthem Blue Cross of IN Traditional	$32,938.29
Rate for Payer: Plain Church Group Ministry All Commercial	$17,980.68
Rate for Payer: Three Rivers Preferred All Commercial	$23,483.99

MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE

Facility

$29,505.39

Service Code	MSDRG 325
Min. Negotiated Rate	$16,106.70
Max. Negotiated Rate	$29,505.39
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$25,014.75
Rate for Payer: Anthem Blue Cross of IN Traditional	$29,505.39
Rate for Payer: Plain Church Group Ministry All Commercial	$16,106.70
Rate for Payer: Three Rivers Preferred All Commercial	$21,036.44

MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC

Facility

$15,933.59

Service Code	MSDRG 073
Min. Negotiated Rate	$8,697.99
Max. Negotiated Rate	$15,933.59
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,508.54
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,933.59
Rate for Payer: Plain Church Group Ministry All Commercial	$8,697.99
Rate for Payer: Three Rivers Preferred All Commercial	$11,360.16

MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC

Facility

$10,746.10

Service Code	MSDRG 074
Min. Negotiated Rate	$5,866.19
Max. Negotiated Rate	$10,746.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,110.58
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,746.10
Rate for Payer: Plain Church Group Ministry All Commercial	$5,866.19
Rate for Payer: Three Rivers Preferred All Commercial	$7,661.64

MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC

Facility

$31,531.11

Service Code	MSDRG 026
Min. Negotiated Rate	$17,212.52
Max. Negotiated Rate	$31,531.11
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$26,732.16
Rate for Payer: Anthem Blue Cross of IN Traditional	$31,531.11
Rate for Payer: Plain Church Group Ministry All Commercial	$17,212.52
Rate for Payer: Three Rivers Preferred All Commercial	$22,480.71

MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC

Facility

$46,104.94

Service Code	MSDRG 025
Min. Negotiated Rate	$25,168.23
Max. Negotiated Rate	$46,104.94
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$39,087.90
Rate for Payer: Anthem Blue Cross of IN Traditional	$46,104.94
Rate for Payer: Plain Church Group Ministry All Commercial	$25,168.23
Rate for Payer: Three Rivers Preferred All Commercial	$32,871.40

MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC

Facility

$25,440.55

Service Code	MSDRG 027
Min. Negotiated Rate	$13,887.74
Max. Negotiated Rate	$25,440.55
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$21,568.57
Rate for Payer: Anthem Blue Cross of IN Traditional	$25,440.55
Rate for Payer: Plain Church Group Ministry All Commercial	$13,887.74
Rate for Payer: Three Rivers Preferred All Commercial	$18,138.33

MS-DRG 42.00: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$70,392.94

Service Code	MSDRG 955
Min. Negotiated Rate	$38,426.80
Max. Negotiated Rate	$70,392.94
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$59,679.34
Rate for Payer: Anthem Blue Cross of IN Traditional	$70,392.94
Rate for Payer: Plain Church Group Ministry All Commercial	$38,426.80
Rate for Payer: Three Rivers Preferred All Commercial	$50,188.00

MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR

Facility

$58,813.88

Service Code	MSDRG 023
Min. Negotiated Rate	$32,105.91
Max. Negotiated Rate	$58,813.88
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$49,862.57
Rate for Payer: Anthem Blue Cross of IN Traditional	$58,813.88
Rate for Payer: Plain Church Group Ministry All Commercial	$32,105.91
Rate for Payer: Three Rivers Preferred All Commercial	$41,932.49

MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC

Facility

$39,191.73

Service Code	MSDRG 024
Min. Negotiated Rate	$21,394.37
Max. Negotiated Rate	$39,191.73
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$33,226.86
Rate for Payer: Anthem Blue Cross of IN Traditional	$39,191.73
Rate for Payer: Plain Church Group Ministry All Commercial	$21,394.37
Rate for Payer: Three Rivers Preferred All Commercial	$27,942.49

MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC

Facility

$20,143.79

Service Code	MSDRG 744
Min. Negotiated Rate	$10,996.29
Max. Negotiated Rate	$20,143.79
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,077.96
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,143.79
Rate for Payer: Plain Church Group Ministry All Commercial	$10,996.29
Rate for Payer: Three Rivers Preferred All Commercial	$14,361.90

MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC

Facility

$10,564.66

Service Code	MSDRG 745
Min. Negotiated Rate	$5,767.14
Max. Negotiated Rate	$10,564.66
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,956.75
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,564.66
Rate for Payer: Plain Church Group Ministry All Commercial	$5,767.14
Rate for Payer: Three Rivers Preferred All Commercial	$7,532.28

MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC

Facility

$12,659.45

Service Code	MSDRG 294
Min. Negotiated Rate	$6,910.67
Max. Negotiated Rate	$12,659.45
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,732.72
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,659.45
Rate for Payer: Plain Church Group Ministry All Commercial	$6,910.67
Rate for Payer: Three Rivers Preferred All Commercial	$9,025.80

MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC

Facility

$8,142.05

Service Code	MSDRG 295
Min. Negotiated Rate	$4,444.66
Max. Negotiated Rate	$8,142.05
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,902.85
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,142.05
Rate for Payer: Plain Church Group Ministry All Commercial	$4,444.66
Rate for Payer: Three Rivers Preferred All Commercial	$5,805.03

MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC

Facility

$25,814.77

Service Code	MSDRG 056
Min. Negotiated Rate	$14,092.02
Max. Negotiated Rate	$25,814.77
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$21,885.83
Rate for Payer: Anthem Blue Cross of IN Traditional	$25,814.77
Rate for Payer: Plain Church Group Ministry All Commercial	$14,092.02
Rate for Payer: Three Rivers Preferred All Commercial	$18,405.13

MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC

Facility

$13,756.33

Service Code	MSDRG 057
Min. Negotiated Rate	$7,509.44
Max. Negotiated Rate	$13,756.33
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,662.66
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,756.33
Rate for Payer: Plain Church Group Ministry All Commercial	$7,509.44
Rate for Payer: Three Rivers Preferred All Commercial	$9,807.84

MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH CC

Facility

$9,696.65

Service Code	MSDRG 158
Min. Negotiated Rate	$5,293.30
Max. Negotiated Rate	$9,696.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,220.84
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,696.65
Rate for Payer: Plain Church Group Ministry All Commercial	$5,293.30
Rate for Payer: Three Rivers Preferred All Commercial	$6,913.41

MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH MCC

Facility

$16,880.99

Service Code	MSDRG 157
Min. Negotiated Rate	$9,215.16
Max. Negotiated Rate	$16,880.99
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,311.75
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,880.99
Rate for Payer: Plain Church Group Ministry All Commercial	$9,215.16
Rate for Payer: Three Rivers Preferred All Commercial	$12,035.62

MS-DRG 42.00: DENTAL AND ORAL DISEASES WITHOUT CC/MCC

Facility

$6,799.82

Service Code	MSDRG 159
Min. Negotiated Rate	$3,711.95
Max. Negotiated Rate	$6,799.82
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,764.90
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,799.82
Rate for Payer: Plain Church Group Ministry All Commercial	$3,711.95
Rate for Payer: Three Rivers Preferred All Commercial	$4,848.06

MS-DRG 42.00: DEPRESSIVE NEUROSES

Facility

$9,423.46

Service Code	MSDRG 881
Min. Negotiated Rate	$5,144.17
Max. Negotiated Rate	$9,423.46
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,989.23
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,423.46
Rate for Payer: Plain Church Group Ministry All Commercial	$5,144.17
Rate for Payer: Three Rivers Preferred All Commercial	$6,718.64

Know your out-of-pocket cost for care.

All Charges