Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC

Facility

$8,136.89

Service Code	MSDRG 093
Min. Negotiated Rate	$4,441.85
Max. Negotiated Rate	$8,136.89
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,898.48
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,136.89
Rate for Payer: Plain Church Group Ministry All Commercial	$4,441.85
Rate for Payer: Three Rivers Preferred All Commercial	$5,801.35

MS-DRG 42.00: OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT

Facility

$13,441.91

Service Code	MSDRG 124
Min. Negotiated Rate	$7,337.80
Max. Negotiated Rate	$13,441.91
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,396.09
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,441.91
Rate for Payer: Plain Church Group Ministry All Commercial	$7,337.80
Rate for Payer: Three Rivers Preferred All Commercial	$9,583.67

MS-DRG 42.00: OTHER DISORDERS OF THE EYE WITHOUT MCC

Facility

$8,512.14

Service Code	MSDRG 125
Min. Negotiated Rate	$4,646.69
Max. Negotiated Rate	$8,512.14
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,216.62
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,512.14
Rate for Payer: Plain Church Group Ministry All Commercial	$4,646.69
Rate for Payer: Three Rivers Preferred All Commercial	$6,068.90

MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC

Facility

$9,624.48

Service Code	MSDRG 155
Min. Negotiated Rate	$5,253.91
Max. Negotiated Rate	$9,624.48
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,159.66
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,624.48
Rate for Payer: Plain Church Group Ministry All Commercial	$5,253.91
Rate for Payer: Three Rivers Preferred All Commercial	$6,861.96

MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC

Facility

$16,765.53

Service Code	MSDRG 154
Min. Negotiated Rate	$9,152.13
Max. Negotiated Rate	$16,765.53
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,213.86
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,765.53
Rate for Payer: Plain Church Group Ministry All Commercial	$9,152.13
Rate for Payer: Three Rivers Preferred All Commercial	$11,953.31

MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC

Facility

$6,931.77

Service Code	MSDRG 156
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: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC

Facility

$18,109.82

Service Code	MSDRG 144
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: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC

Facility

$34,039.29

Service Code	MSDRG 143
Min. Negotiated Rate	$18,581.71
Max. Negotiated Rate	$34,039.29
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$28,858.61
Rate for Payer: Anthem Blue Cross of IN Traditional	$34,039.29
Rate for Payer: Plain Church Group Ministry All Commercial	$18,581.71
Rate for Payer: Three Rivers Preferred All Commercial	$24,268.97

MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC

Facility

$12,214.10

Service Code	MSDRG 145
Min. Negotiated Rate	$6,667.56
Max. Negotiated Rate	$12,214.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,355.15
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,214.10
Rate for Payer: Plain Church Group Ministry All Commercial	$6,667.56
Rate for Payer: Three Rivers Preferred All Commercial	$8,708.28

MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC

Facility

$23,185.97

Service Code	MSDRG 629
Min. Negotiated Rate	$12,656.99
Max. Negotiated Rate	$23,185.97
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$19,657.13
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,185.97
Rate for Payer: Plain Church Group Ministry All Commercial	$12,656.99
Rate for Payer: Three Rivers Preferred All Commercial	$16,530.88

MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC

Facility

$40,676.22

Service Code	MSDRG 628
Min. Negotiated Rate	$22,204.74
Max. Negotiated Rate	$40,676.22
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$34,485.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$40,676.22
Rate for Payer: Plain Church Group Ministry All Commercial	$22,204.74
Rate for Payer: Three Rivers Preferred All Commercial	$29,000.90

MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC

Facility

$14,446.00

Service Code	MSDRG 630
Min. Negotiated Rate	$7,885.93
Max. Negotiated Rate	$14,446.00
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,247.36
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,446.00
Rate for Payer: Plain Church Group Ministry All Commercial	$7,885.93
Rate for Payer: Three Rivers Preferred All Commercial	$10,299.56

MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC

Facility

$45,285.38

Service Code	MSDRG 319
Min. Negotiated Rate	$24,720.83
Max. Negotiated Rate	$45,285.38
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$38,393.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$45,285.38
Rate for Payer: Plain Church Group Ministry All Commercial	$24,720.83
Rate for Payer: Three Rivers Preferred All Commercial	$32,287.08

MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC

Facility

$23,863.27

Service Code	MSDRG 320
Min. Negotiated Rate	$13,026.72
Max. Negotiated Rate	$23,863.27
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$20,231.35
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,863.27
Rate for Payer: Plain Church Group Ministry All Commercial	$13,026.72
Rate for Payer: Three Rivers Preferred All Commercial	$17,013.78

MS-DRG 42.00: OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$5,845.20

Service Code	MSDRG 951
Min. Negotiated Rate	$3,190.84
Max. Negotiated Rate	$5,845.20
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$4,955.58
Rate for Payer: Anthem Blue Cross of IN Traditional	$5,845.20
Rate for Payer: Plain Church Group Ministry All Commercial	$3,190.84
Rate for Payer: Three Rivers Preferred All Commercial	$4,167.45

MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC

Facility

$26,685.88

Service Code	MSDRG 749
Min. Negotiated Rate	$14,567.55
Max. Negotiated Rate	$26,685.88
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$22,624.36
Rate for Payer: Anthem Blue Cross of IN Traditional	$26,685.88
Rate for Payer: Plain Church Group Ministry All Commercial	$14,567.55
Rate for Payer: Three Rivers Preferred All Commercial	$19,026.21

MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$13,293.46

Service Code	MSDRG 750
Min. Negotiated Rate	$7,256.76
Max. Negotiated Rate	$13,293.46
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,270.23
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,293.46
Rate for Payer: Plain Church Group Ministry All Commercial	$7,256.76
Rate for Payer: Three Rivers Preferred All Commercial	$9,477.83

MS-DRG 42.00: OTHER HEART ASSIST SYSTEM IMPLANT

Facility

$109,221.79

Service Code	MSDRG 215
Min. Negotiated Rate	$59,623.08
Max. Negotiated Rate	$109,221.79
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$92,598.55
Rate for Payer: Anthem Blue Cross of IN Traditional	$109,221.79
Rate for Payer: Plain Church Group Ministry All Commercial	$59,623.08
Rate for Payer: Three Rivers Preferred All Commercial	$77,871.78

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC

Facility

$23,538.54

Service Code	MSDRG 424
Min. Negotiated Rate	$12,849.45
Max. Negotiated Rate	$23,538.54
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$19,956.04
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,538.54
Rate for Payer: Plain Church Group Ministry All Commercial	$12,849.45
Rate for Payer: Three Rivers Preferred All Commercial	$16,782.26

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC

Facility

$41,930.83

Service Code	MSDRG 423
Min. Negotiated Rate	$22,889.62
Max. Negotiated Rate	$41,930.83
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$35,549.08
Rate for Payer: Anthem Blue Cross of IN Traditional	$41,930.83
Rate for Payer: Plain Church Group Ministry All Commercial	$22,889.62
Rate for Payer: Three Rivers Preferred All Commercial	$29,895.39

MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC

Facility

$15,935.65

Service Code	MSDRG 425
Min. Negotiated Rate	$8,699.11
Max. Negotiated Rate	$15,935.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,510.29
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,935.65
Rate for Payer: Plain Church Group Ministry All Commercial	$8,699.11
Rate for Payer: Three Rivers Preferred All Commercial	$11,361.63

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC

Facility

$10,825.48

Service Code	MSDRG 868
Min. Negotiated Rate	$5,909.52
Max. Negotiated Rate	$10,825.48
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,177.87
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,825.48
Rate for Payer: Plain Church Group Ministry All Commercial	$5,909.52
Rate for Payer: Three Rivers Preferred All Commercial	$7,718.23

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC

Facility

$22,105.59

Service Code	MSDRG 867
Min. Negotiated Rate	$12,067.22
Max. Negotiated Rate	$22,105.59
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$18,741.18
Rate for Payer: Anthem Blue Cross of IN Traditional	$22,105.59
Rate for Payer: Plain Church Group Ministry All Commercial	$12,067.22
Rate for Payer: Three Rivers Preferred All Commercial	$15,760.60

MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC

Facility

$7,418.36

Service Code	MSDRG 869
Min. Negotiated Rate	$4,049.61
Max. Negotiated Rate	$7,418.36
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,289.30
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,418.36
Rate for Payer: Plain Church Group Ministry All Commercial	$4,049.61
Rate for Payer: Three Rivers Preferred All Commercial	$5,289.06

MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility

$17,416.02

Service Code	MSDRG 922
Min. Negotiated Rate	$9,507.23
Max. Negotiated Rate	$17,416.02
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,765.36
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,416.02
Rate for Payer: Plain Church Group Ministry All Commercial	$9,507.23
Rate for Payer: Three Rivers Preferred All Commercial	$12,417.09

Know your out-of-pocket cost for care.

All Charges