Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC

Facility

$48,500.75

Service Code	MSDRG 267
Min. Negotiated Rate	$26,476.08
Max. Negotiated Rate	$48,500.75
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$41,119.08
Rate for Payer: Anthem Blue Cross of IN Traditional	$48,500.75
Rate for Payer: Plain Church Group Ministry All Commercial	$26,476.08
Rate for Payer: Three Rivers Preferred All Commercial	$34,579.54

MS-DRG 42.00: EPISTAXIS WITH MCC

Facility

$14,249.10

Service Code	MSDRG 150
Min. Negotiated Rate	$7,778.44
Max. Negotiated Rate	$14,249.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,080.43
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,249.10
Rate for Payer: Plain Church Group Ministry All Commercial	$7,778.44
Rate for Payer: Three Rivers Preferred All Commercial	$10,159.17

MS-DRG 42.00: EPISTAXIS WITHOUT MCC

Facility

$7,814.22

Service Code	MSDRG 151
Min. Negotiated Rate	$4,265.71
Max. Negotiated Rate	$7,814.22
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,624.92
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,814.22
Rate for Payer: Plain Church Group Ministry All Commercial	$4,265.71
Rate for Payer: Three Rivers Preferred All Commercial	$5,571.30

MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC

Facility

$13,241.91

Service Code	MSDRG 391
Min. Negotiated Rate	$7,228.63
Max. Negotiated Rate	$13,241.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,226.53
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,241.91
Rate for Payer: Plain Church Group Ministry All Commercial	$7,228.63
Rate for Payer: Three Rivers Preferred All Commercial	$9,441.08

MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC

Facility

$8,044.11

Service Code	MSDRG 392
Min. Negotiated Rate	$4,391.20
Max. Negotiated Rate	$8,044.11
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,819.82
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,044.11
Rate for Payer: Plain Church Group Ministry All Commercial	$4,391.20
Rate for Payer: Three Rivers Preferred All Commercial	$5,735.20

MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT

Facility

$44,606.01

Service Code	MSDRG 933
Min. Negotiated Rate	$24,349.98
Max. Negotiated Rate	$44,606.01
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$37,817.11
Rate for Payer: Anthem Blue Cross of IN Traditional	$44,606.01
Rate for Payer: Plain Church Group Ministry All Commercial	$24,349.98
Rate for Payer: Three Rivers Preferred All Commercial	$31,802.72

MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT

Facility

$244,558.35

Service Code	MSDRG 927
Min. Negotiated Rate	$133,501.95
Max. Negotiated Rate	$244,558.35
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$207,337.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$244,558.35
Rate for Payer: Plain Church Group Ministry All Commercial	$133,501.95
Rate for Payer: Three Rivers Preferred All Commercial	$174,362.58

MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC

Facility

$25,239.52

Service Code	MSDRG 982
Min. Negotiated Rate	$13,778.00
Max. Negotiated Rate	$25,239.52
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$21,398.14
Rate for Payer: Anthem Blue Cross of IN Traditional	$25,239.52
Rate for Payer: Plain Church Group Ministry All Commercial	$13,778.00
Rate for Payer: Three Rivers Preferred All Commercial	$17,995.01

MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC

Facility

$49,007.96

Service Code	MSDRG 981
Min. Negotiated Rate	$26,752.95
Max. Negotiated Rate	$49,007.96
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$41,549.09
Rate for Payer: Anthem Blue Cross of IN Traditional	$49,007.96
Rate for Payer: Plain Church Group Ministry All Commercial	$26,752.95
Rate for Payer: Three Rivers Preferred All Commercial	$34,941.17

MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

Facility

$17,197.47

Service Code	MSDRG 983
Min. Negotiated Rate	$9,387.93
Max. Negotiated Rate	$17,197.47
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,580.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,197.47
Rate for Payer: Plain Church Group Ministry All Commercial	$9,387.93
Rate for Payer: Three Rivers Preferred All Commercial	$12,261.27

MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH CC

Facility

$16,610.89

Service Code	MSDRG 038
Min. Negotiated Rate	$9,067.72
Max. Negotiated Rate	$16,610.89
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,082.76
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,610.89
Rate for Payer: Plain Church Group Ministry All Commercial	$9,067.72
Rate for Payer: Three Rivers Preferred All Commercial	$11,843.06

MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH MCC

Facility

$34,235.16

Service Code	MSDRG 037
Min. Negotiated Rate	$18,688.63
Max. Negotiated Rate	$34,235.16
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$29,024.67
Rate for Payer: Anthem Blue Cross of IN Traditional	$34,235.16
Rate for Payer: Plain Church Group Ministry All Commercial	$18,688.63
Rate for Payer: Three Rivers Preferred All Commercial	$24,408.62

MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC

Facility

$11,733.70

Service Code	MSDRG 039
Min. Negotiated Rate	$6,405.31
Max. Negotiated Rate	$11,733.70
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,947.87
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,733.70
Rate for Payer: Plain Church Group Ministry All Commercial	$6,405.31
Rate for Payer: Three Rivers Preferred All Commercial	$8,365.77

MS-DRG 42.00: EXTRAOCULAR PROCEDURES EXCEPT ORBIT

Facility

$15,783.08

Service Code	MSDRG 115
Min. Negotiated Rate	$8,615.82
Max. Negotiated Rate	$15,783.08
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,380.94
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,783.08
Rate for Payer: Plain Church Group Ministry All Commercial	$8,615.82
Rate for Payer: Three Rivers Preferred All Commercial	$11,252.85

MS-DRG 42.00: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE

Facility

$61,284.94

Service Code	MSDRG 790
Min. Negotiated Rate	$33,454.84
Max. Negotiated Rate	$61,284.94
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$51,957.55
Rate for Payer: Anthem Blue Cross of IN Traditional	$61,284.94
Rate for Payer: Plain Church Group Ministry All Commercial	$33,454.84
Rate for Payer: Three Rivers Preferred All Commercial	$43,694.28

MS-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

$14,043.95

Service Code	MSDRG 748
Min. Negotiated Rate	$7,666.45
Max. Negotiated Rate	$14,043.95
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,906.50
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,043.95
Rate for Payer: Plain Church Group Ministry All Commercial	$7,666.45
Rate for Payer: Three Rivers Preferred All Commercial	$10,012.91

MS-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS

Facility

$9,257.48

Service Code	MSDRG 864
Min. Negotiated Rate	$5,053.57
Max. Negotiated Rate	$9,257.48
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,848.52
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,257.48
Rate for Payer: Plain Church Group Ministry All Commercial	$5,053.57
Rate for Payer: Three Rivers Preferred All Commercial	$6,600.30

MS-DRG 42.00: FOOT PROCEDURES WITH CC

Facility

$18,092.29

Service Code	MSDRG 504
Min. Negotiated Rate	$9,876.40
Max. Negotiated Rate	$18,092.29
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,338.70
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,092.29
Rate for Payer: Plain Church Group Ministry All Commercial	$9,876.40
Rate for Payer: Three Rivers Preferred All Commercial	$12,899.25

MS-DRG 42.00: FOOT PROCEDURES WITH MCC

Facility

$27,283.80

Service Code	MSDRG 503
Min. Negotiated Rate	$14,893.95
Max. Negotiated Rate	$27,283.80
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$23,131.28
Rate for Payer: Anthem Blue Cross of IN Traditional	$27,283.80
Rate for Payer: Plain Church Group Ministry All Commercial	$14,893.95
Rate for Payer: Three Rivers Preferred All Commercial	$19,452.51

MS-DRG 42.00: FOOT PROCEDURES WITHOUT CC/MCC

Facility

$18,092.29

Service Code	MSDRG 505
Min. Negotiated Rate	$9,876.40
Max. Negotiated Rate	$18,092.29
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,338.70
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,092.29
Rate for Payer: Plain Church Group Ministry All Commercial	$9,876.40
Rate for Payer: Three Rivers Preferred All Commercial	$12,899.25

MS-DRG 42.00: FRACTURES OF FEMUR WITH MCC

Facility

$15,720.19

Service Code	MSDRG 533
Min. Negotiated Rate	$8,581.50
Max. Negotiated Rate	$15,720.19
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,327.63
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,720.19
Rate for Payer: Plain Church Group Ministry All Commercial	$8,581.50
Rate for Payer: Three Rivers Preferred All Commercial	$11,208.01

MS-DRG 42.00: FRACTURES OF FEMUR WITHOUT MCC

Facility

$8,391.53

Service Code	MSDRG 534
Min. Negotiated Rate	$4,580.85
Max. Negotiated Rate	$8,391.53
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,114.36
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,391.53
Rate for Payer: Plain Church Group Ministry All Commercial	$4,580.85
Rate for Payer: Three Rivers Preferred All Commercial	$5,982.90

MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITH MCC

Facility

$13,709.94

Service Code	MSDRG 535
Min. Negotiated Rate	$7,484.12
Max. Negotiated Rate	$13,709.94
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,623.33
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,709.94
Rate for Payer: Plain Church Group Ministry All Commercial	$7,484.12
Rate for Payer: Three Rivers Preferred All Commercial	$9,774.76

MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITHOUT MCC

Facility

$8,359.57

Service Code	MSDRG 536
Min. Negotiated Rate	$4,563.40
Max. Negotiated Rate	$8,359.57
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,087.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,359.57
Rate for Payer: Plain Church Group Ministry All Commercial	$4,563.40
Rate for Payer: Three Rivers Preferred All Commercial	$5,960.11

MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC

Facility

$15,087.22

Service Code	MSDRG 562
Min. Negotiated Rate	$8,235.96
Max. Negotiated Rate	$15,087.22
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,790.99
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,087.22
Rate for Payer: Plain Church Group Ministry All Commercial	$8,235.96
Rate for Payer: Three Rivers Preferred All Commercial	$10,756.73

Know your out-of-pocket cost for care.

All Charges