Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC

Facility

$13,814.06

Service Code	MSDRG 660
Min. Negotiated Rate	$7,540.96
Max. Negotiated Rate	$13,814.06
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,711.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,814.06
Rate for Payer: Plain Church Group Ministry All Commercial	$7,540.96
Rate for Payer: Three Rivers Preferred All Commercial	$9,849.00

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC

Facility

$26,641.55

Service Code	MSDRG 659
Min. Negotiated Rate	$14,543.35
Max. Negotiated Rate	$26,641.55
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$22,586.78
Rate for Payer: Anthem Blue Cross of IN Traditional	$26,641.55
Rate for Payer: Plain Church Group Ministry All Commercial	$14,543.35
Rate for Payer: Three Rivers Preferred All Commercial	$18,994.60

MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC

Facility

$10,583.22

Service Code	MSDRG 661
Min. Negotiated Rate	$5,777.27
Max. Negotiated Rate	$10,583.22
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,972.48
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,583.22
Rate for Payer: Plain Church Group Ministry All Commercial	$5,777.27
Rate for Payer: Three Rivers Preferred All Commercial	$7,545.51

MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC

Facility

$12,064.62

Service Code	MSDRG 689
Min. Negotiated Rate	$6,585.96
Max. Negotiated Rate	$12,064.62
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,228.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,064.62
Rate for Payer: Plain Church Group Ministry All Commercial	$6,585.96
Rate for Payer: Three Rivers Preferred All Commercial	$8,601.70

MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC

Facility

$8,274.00

Service Code	MSDRG 690
Min. Negotiated Rate	$4,516.70
Max. Negotiated Rate	$8,274.00
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,014.72
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,274.00
Rate for Payer: Plain Church Group Ministry All Commercial	$4,516.70
Rate for Payer: Three Rivers Preferred All Commercial	$5,899.11

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC

Facility

$10,852.28

Service Code	MSDRG 687
Min. Negotiated Rate	$5,924.15
Max. Negotiated Rate	$10,852.28
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,200.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,852.28
Rate for Payer: Plain Church Group Ministry All Commercial	$5,924.15
Rate for Payer: Three Rivers Preferred All Commercial	$7,737.35

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC

Facility

$19,439.68

Service Code	MSDRG 686
Min. Negotiated Rate	$10,611.93
Max. Negotiated Rate	$19,439.68
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,481.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,439.68
Rate for Payer: Plain Church Group Ministry All Commercial	$10,611.93
Rate for Payer: Three Rivers Preferred All Commercial	$13,859.90

MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC

Facility

$7,465.78

Service Code	MSDRG 688
Min. Negotiated Rate	$4,075.49
Max. Negotiated Rate	$7,465.78
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,329.51
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,465.78
Rate for Payer: Plain Church Group Ministry All Commercial	$4,075.49
Rate for Payer: Three Rivers Preferred All Commercial	$5,322.87

MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC

Facility

$11,626.49

Service Code	MSDRG 695
Min. Negotiated Rate	$6,346.78
Max. Negotiated Rate	$11,626.49
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,856.97
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,626.49
Rate for Payer: Plain Church Group Ministry All Commercial	$6,346.78
Rate for Payer: Three Rivers Preferred All Commercial	$8,289.33

MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$7,131.77

Service Code	MSDRG 696
Min. Negotiated Rate	$3,893.16
Max. Negotiated Rate	$7,131.77
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,046.33
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,131.77
Rate for Payer: Plain Church Group Ministry All Commercial	$3,893.16
Rate for Payer: Three Rivers Preferred All Commercial	$5,084.73

MS-DRG 42.00: KIDNEY TRANSPLANT

Facility

$31,663.06

Service Code	MSDRG 652
Min. Negotiated Rate	$17,284.55
Max. Negotiated Rate	$31,663.06
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$26,844.04
Rate for Payer: Anthem Blue Cross of IN Traditional	$31,663.06
Rate for Payer: Plain Church Group Ministry All Commercial	$17,284.55
Rate for Payer: Three Rivers Preferred All Commercial	$22,574.79

MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC

Facility

$47,496.66

Service Code	MSDRG 650
Min. Negotiated Rate	$25,927.95
Max. Negotiated Rate	$47,496.66
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$40,267.80
Rate for Payer: Anthem Blue Cross of IN Traditional	$47,496.66
Rate for Payer: Plain Church Group Ministry All Commercial	$25,927.95
Rate for Payer: Three Rivers Preferred All Commercial	$33,863.65

MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC

Facility

$35,798.00

Service Code	MSDRG 651
Min. Negotiated Rate	$19,541.77
Max. Negotiated Rate	$35,798.00
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$30,349.65
Rate for Payer: Anthem Blue Cross of IN Traditional	$35,798.00
Rate for Payer: Plain Church Group Ministry All Commercial	$19,541.77
Rate for Payer: Three Rivers Preferred All Commercial	$25,522.88

MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC

Facility

$20,261.31

Service Code	MSDRG 488
Min. Negotiated Rate	$11,060.45
Max. Negotiated Rate	$20,261.31
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,177.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,261.31
Rate for Payer: Plain Church Group Ministry All Commercial	$11,060.45
Rate for Payer: Three Rivers Preferred All Commercial	$14,445.69

MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC

Facility

$12,766.67

Service Code	MSDRG 489
Min. Negotiated Rate	$6,969.20
Max. Negotiated Rate	$12,766.67
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,823.62
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,766.67
Rate for Payer: Plain Church Group Ministry All Commercial	$6,969.20
Rate for Payer: Three Rivers Preferred All Commercial	$9,102.24

MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC

Facility

$21,864.36

Service Code	MSDRG 486
Min. Negotiated Rate	$11,935.53
Max. Negotiated Rate	$21,864.36
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$18,536.67
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,864.36
Rate for Payer: Plain Church Group Ministry All Commercial	$11,935.53
Rate for Payer: Three Rivers Preferred All Commercial	$15,588.61

MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC

Facility

$33,187.76

Service Code	MSDRG 485
Min. Negotiated Rate	$18,116.87
Max. Negotiated Rate	$33,187.76
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$28,136.68
Rate for Payer: Anthem Blue Cross of IN Traditional	$33,187.76
Rate for Payer: Plain Church Group Ministry All Commercial	$18,116.87
Rate for Payer: Three Rivers Preferred All Commercial	$23,661.85

MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC

Facility

$16,290.28

Service Code	MSDRG 487
Min. Negotiated Rate	$8,892.70
Max. Negotiated Rate	$16,290.28
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,810.95
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,290.28
Rate for Payer: Plain Church Group Ministry All Commercial	$8,892.70
Rate for Payer: Three Rivers Preferred All Commercial	$11,614.47

MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC

Facility

$17,096.45

Service Code	MSDRG 418
Min. Negotiated Rate	$9,332.78
Max. Negotiated Rate	$17,096.45
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,494.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,096.45
Rate for Payer: Plain Church Group Ministry All Commercial	$9,332.78
Rate for Payer: Three Rivers Preferred All Commercial	$12,189.24

MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC

Facility

$24,499.34

Service Code	MSDRG 417
Min. Negotiated Rate	$13,373.94
Max. Negotiated Rate	$24,499.34
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$20,770.61
Rate for Payer: Anthem Blue Cross of IN Traditional	$24,499.34
Rate for Payer: Plain Church Group Ministry All Commercial	$13,373.94
Rate for Payer: Three Rivers Preferred All Commercial	$17,467.28

MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$13,583.14

Service Code	MSDRG 419
Min. Negotiated Rate	$7,414.90
Max. Negotiated Rate	$13,583.14
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,515.82
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,583.14
Rate for Payer: Plain Church Group Ministry All Commercial	$7,414.90
Rate for Payer: Three Rivers Preferred All Commercial	$9,684.36

MS-DRG 42.00: LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$39,405.12

Service Code	MSDRG 956
Min. Negotiated Rate	$21,510.86
Max. Negotiated Rate	$39,405.12
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$33,407.78
Rate for Payer: Anthem Blue Cross of IN Traditional	$39,405.12
Rate for Payer: Plain Church Group Ministry All Commercial	$21,510.86
Rate for Payer: Three Rivers Preferred All Commercial	$28,094.64

MS-DRG 42.00: LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT

Facility

$109,784.66

Service Code	MSDRG 005
Min. Negotiated Rate	$59,930.35
Max. Negotiated Rate	$109,784.66
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$93,075.76
Rate for Payer: Anthem Blue Cross of IN Traditional	$109,784.66
Rate for Payer: Plain Church Group Ministry All Commercial	$59,930.35
Rate for Payer: Three Rivers Preferred All Commercial	$78,273.09

MS-DRG 42.00: LIVER TRANSPLANT WITHOUT MCC

Facility

$49,990.40

Service Code	MSDRG 006
Min. Negotiated Rate	$27,289.26
Max. Negotiated Rate	$49,990.40
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$42,382.01
Rate for Payer: Anthem Blue Cross of IN Traditional	$49,990.40
Rate for Payer: Plain Church Group Ministry All Commercial	$27,289.26
Rate for Payer: Three Rivers Preferred All Commercial	$35,641.62

MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC

Facility

$20,339.66

Service Code	MSDRG 496
Min. Negotiated Rate	$11,103.22
Max. Negotiated Rate	$20,339.66
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,244.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,339.66
Rate for Payer: Plain Church Group Ministry All Commercial	$11,103.22
Rate for Payer: Three Rivers Preferred All Commercial	$14,501.55

Know your out-of-pocket cost for care.

All Charges