Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility

$10,514.15

Service Code	MSDRG 923
Min. Negotiated Rate	$5,739.57
Max. Negotiated Rate	$10,514.15
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,913.93
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,514.15
Rate for Payer: Plain Church Group Ministry All Commercial	$5,739.57
Rate for Payer: Three Rivers Preferred All Commercial	$7,496.27

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC

Facility

$10,514.15

Service Code	MSDRG 699
Min. Negotiated Rate	$5,739.57
Max. Negotiated Rate	$10,514.15
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,913.93
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,514.15
Rate for Payer: Plain Church Group Ministry All Commercial	$5,739.57
Rate for Payer: Three Rivers Preferred All Commercial	$7,496.27

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC

Facility

$17,328.40

Service Code	MSDRG 698
Min. Negotiated Rate	$9,459.40
Max. Negotiated Rate	$17,328.40
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,691.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,328.40
Rate for Payer: Plain Church Group Ministry All Commercial	$9,459.40
Rate for Payer: Three Rivers Preferred All Commercial	$12,354.61

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

Facility

$7,156.51

Service Code	MSDRG 700
Min. Negotiated Rate	$3,906.67
Max. Negotiated Rate	$7,156.51
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,067.31
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,156.51
Rate for Payer: Plain Church Group Ministry All Commercial	$3,906.67
Rate for Payer: Three Rivers Preferred All Commercial	$5,102.37

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC

Facility

$23,797.30

Service Code	MSDRG 674
Min. Negotiated Rate	$12,990.71
Max. Negotiated Rate	$23,797.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$20,175.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,797.30
Rate for Payer: Plain Church Group Ministry All Commercial	$12,990.71
Rate for Payer: Three Rivers Preferred All Commercial	$16,966.74

MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC

Facility

$43,190.59

Service Code	MSDRG 673
Min. Negotiated Rate	$23,577.31
Max. Negotiated Rate	$43,190.59
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$36,617.10
Rate for Payer: Anthem Blue Cross of IN Traditional	$43,190.59
Rate for Payer: Plain Church Group Ministry All Commercial	$23,577.31
Rate for Payer: Three Rivers Preferred All Commercial	$30,793.56

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

Facility

$16,136.68

Service Code	MSDRG 675
Min. Negotiated Rate	$8,808.85
Max. Negotiated Rate	$16,136.68
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,680.72
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,136.68
Rate for Payer: Plain Church Group Ministry All Commercial	$8,808.85
Rate for Payer: Three Rivers Preferred All Commercial	$11,504.95

MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC

Facility

$35,508.32

Service Code	MSDRG 271
Min. Negotiated Rate	$19,383.64
Max. Negotiated Rate	$35,508.32
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$30,104.06
Rate for Payer: Anthem Blue Cross of IN Traditional	$35,508.32
Rate for Payer: Plain Church Group Ministry All Commercial	$19,383.64
Rate for Payer: Three Rivers Preferred All Commercial	$25,316.34

MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC

Facility

$52,916.10

Service Code	MSDRG 270
Min. Negotiated Rate	$28,886.37
Max. Negotiated Rate	$52,916.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$44,862.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$52,916.10
Rate for Payer: Plain Church Group Ministry All Commercial	$28,886.37
Rate for Payer: Three Rivers Preferred All Commercial	$37,727.55

MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$25,795.18

Service Code	MSDRG 272
Min. Negotiated Rate	$14,081.33
Max. Negotiated Rate	$25,795.18
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$21,869.23
Rate for Payer: Anthem Blue Cross of IN Traditional	$25,795.18
Rate for Payer: Plain Church Group Ministry All Commercial	$14,081.33
Rate for Payer: Three Rivers Preferred All Commercial	$18,391.17

MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC

Facility

$11,349.18

Service Code	MSDRG 729
Min. Negotiated Rate	$6,195.40
Max. Negotiated Rate	$11,349.18
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,621.87
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,349.18
Rate for Payer: Plain Church Group Ministry All Commercial	$6,195.40
Rate for Payer: Three Rivers Preferred All Commercial	$8,091.61

MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility

$6,256.53

Service Code	MSDRG 730
Min. Negotiated Rate	$3,415.38
Max. Negotiated Rate	$6,256.53
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,304.31
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,256.53
Rate for Payer: Plain Church Group Ministry All Commercial	$3,415.38
Rate for Payer: Three Rivers Preferred All Commercial	$4,460.72

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

Facility

$19,128.35

Service Code	MSDRG 717
Min. Negotiated Rate	$10,441.97
Max. Negotiated Rate	$19,128.35
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,217.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,128.35
Rate for Payer: Plain Church Group Ministry All Commercial	$10,441.97
Rate for Payer: Three Rivers Preferred All Commercial	$13,637.92

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

Facility

$12,699.66

Service Code	MSDRG 718
Min. Negotiated Rate	$6,932.62
Max. Negotiated Rate	$12,699.66
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,766.81
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,699.66
Rate for Payer: Plain Church Group Ministry All Commercial	$6,932.62
Rate for Payer: Three Rivers Preferred All Commercial	$9,054.47

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

Facility

$23,280.81

Service Code	MSDRG 715
Min. Negotiated Rate	$12,708.76
Max. Negotiated Rate	$23,280.81
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$19,737.54
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,280.81
Rate for Payer: Plain Church Group Ministry All Commercial	$12,708.76
Rate for Payer: Three Rivers Preferred All Commercial	$16,598.51

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

Facility

$14,631.56

Service Code	MSDRG 716
Min. Negotiated Rate	$7,987.22
Max. Negotiated Rate	$14,631.56
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,404.68
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,631.56
Rate for Payer: Plain Church Group Ministry All Commercial	$7,987.22
Rate for Payer: Three Rivers Preferred All Commercial	$10,431.85

MS-DRG 42.00: OTHER MENTAL DISORDER DIAGNOSES

Facility

$12,261.52

Service Code	MSDRG 887
Min. Negotiated Rate	$6,693.44
Max. Negotiated Rate	$12,261.52
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,395.36
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,261.52
Rate for Payer: Plain Church Group Ministry All Commercial	$6,693.44
Rate for Payer: Three Rivers Preferred All Commercial	$8,742.09

MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$15,464.53

Service Code	MSDRG 964
Min. Negotiated Rate	$8,441.93
Max. Negotiated Rate	$15,464.53
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,110.87
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,464.53
Rate for Payer: Plain Church Group Ministry All Commercial	$8,441.93
Rate for Payer: Three Rivers Preferred All Commercial	$11,025.74

MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$28,006.46

Service Code	MSDRG 963
Min. Negotiated Rate	$15,288.45
Max. Negotiated Rate	$28,006.46
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$23,743.96
Rate for Payer: Anthem Blue Cross of IN Traditional	$28,006.46
Rate for Payer: Plain Church Group Ministry All Commercial	$15,288.45
Rate for Payer: Three Rivers Preferred All Commercial	$19,967.74

MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$9,407.99

Service Code	MSDRG 965
Min. Negotiated Rate	$5,135.73
Max. Negotiated Rate	$9,407.99
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,976.12
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,407.99
Rate for Payer: Plain Church Group Ministry All Commercial	$5,135.73
Rate for Payer: Three Rivers Preferred All Commercial	$6,707.61

MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC

Facility

$10,512.09

Service Code	MSDRG 565
Min. Negotiated Rate	$5,738.44
Max. Negotiated Rate	$10,512.09
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,912.18
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,512.09
Rate for Payer: Plain Church Group Ministry All Commercial	$5,738.44
Rate for Payer: Three Rivers Preferred All Commercial	$7,494.80

MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC

Facility

$16,176.88

Service Code	MSDRG 564
Min. Negotiated Rate	$8,830.80
Max. Negotiated Rate	$16,176.88
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,714.81
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,176.88
Rate for Payer: Plain Church Group Ministry All Commercial	$8,830.80
Rate for Payer: Three Rivers Preferred All Commercial	$11,533.62

MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC

Facility

$7,712.16

Service Code	MSDRG 566
Min. Negotiated Rate	$4,209.99
Max. Negotiated Rate	$7,712.16
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,538.39
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,712.16
Rate for Payer: Plain Church Group Ministry All Commercial	$4,209.99
Rate for Payer: Three Rivers Preferred All Commercial	$5,498.53

MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC

Facility

$20,738.62

Service Code	MSDRG 516
Min. Negotiated Rate	$11,321.00
Max. Negotiated Rate	$20,738.62
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,582.26
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,738.62
Rate for Payer: Plain Church Group Ministry All Commercial	$11,321.00
Rate for Payer: Three Rivers Preferred All Commercial	$14,786.00

MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC

Facility

$31,879.55

Service Code	MSDRG 515
Min. Negotiated Rate	$17,402.73
Max. Negotiated Rate	$31,879.55
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$27,027.58
Rate for Payer: Anthem Blue Cross of IN Traditional	$31,879.55
Rate for Payer: Plain Church Group Ministry All Commercial	$17,402.73
Rate for Payer: Three Rivers Preferred All Commercial	$22,729.14

Know your out-of-pocket cost for care.

All Charges