Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC

Facility

$15,388.24

Service Code	MSDRG 517
Min. Negotiated Rate	$8,400.29
Max. Negotiated Rate	$15,388.24
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,046.20
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,388.24
Rate for Payer: Plain Church Group Ministry All Commercial	$8,400.29
Rate for Payer: Three Rivers Preferred All Commercial	$10,971.34

MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC

Facility

$12,321.32

Service Code	MSDRG 844
Min. Negotiated Rate	$6,726.08
Max. Negotiated Rate	$12,321.32
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,446.05
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,321.32
Rate for Payer: Plain Church Group Ministry All Commercial	$6,726.08
Rate for Payer: Three Rivers Preferred All Commercial	$8,784.72

MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC

Facility

$19,518.03

Service Code	MSDRG 843
Min. Negotiated Rate	$10,654.70
Max. Negotiated Rate	$19,518.03
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,547.44
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,518.03
Rate for Payer: Plain Church Group Ministry All Commercial	$10,654.70
Rate for Payer: Three Rivers Preferred All Commercial	$13,915.75

MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC

Facility

$8,626.57

Service Code	MSDRG 845
Min. Negotiated Rate	$4,709.16
Max. Negotiated Rate	$8,626.57
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,313.63
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,626.57
Rate for Payer: Plain Church Group Ministry All Commercial	$4,709.16
Rate for Payer: Three Rivers Preferred All Commercial	$6,150.48

MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITH CC

Facility

$20,794.28

Service Code	MSDRG 908
Min. Negotiated Rate	$11,351.39
Max. Negotiated Rate	$20,794.28
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,629.45
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,794.28
Rate for Payer: Plain Church Group Ministry All Commercial	$11,351.39
Rate for Payer: Three Rivers Preferred All Commercial	$14,825.68

MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITH MCC

Facility

$41,067.96

Service Code	MSDRG 907
Min. Negotiated Rate	$22,418.59
Max. Negotiated Rate	$41,067.96
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$34,817.54
Rate for Payer: Anthem Blue Cross of IN Traditional	$41,067.96
Rate for Payer: Plain Church Group Ministry All Commercial	$22,418.59
Rate for Payer: Three Rivers Preferred All Commercial	$29,280.19

MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC

Facility

$13,074.90

Service Code	MSDRG 909
Min. Negotiated Rate	$7,137.46
Max. Negotiated Rate	$13,074.90
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,084.94
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,074.90
Rate for Payer: Plain Church Group Ministry All Commercial	$7,137.46
Rate for Payer: Three Rivers Preferred All Commercial	$9,322.00

MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$42,367.93

Service Code	MSDRG 958
Min. Negotiated Rate	$23,128.23
Max. Negotiated Rate	$42,367.93
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$35,919.65
Rate for Payer: Anthem Blue Cross of IN Traditional	$42,367.93
Rate for Payer: Plain Church Group Ministry All Commercial	$23,128.23
Rate for Payer: Three Rivers Preferred All Commercial	$30,207.03

MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$76,948.44

Service Code	MSDRG 957
Min. Negotiated Rate	$42,005.38
Max. Negotiated Rate	$76,948.44
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$65,237.11
Rate for Payer: Anthem Blue Cross of IN Traditional	$76,948.44
Rate for Payer: Plain Church Group Ministry All Commercial	$42,005.38
Rate for Payer: Three Rivers Preferred All Commercial	$54,861.87

MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$27,255.97

Service Code	MSDRG 959
Min. Negotiated Rate	$14,878.76
Max. Negotiated Rate	$27,255.97
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$23,107.69
Rate for Payer: Anthem Blue Cross of IN Traditional	$27,255.97
Rate for Payer: Plain Church Group Ministry All Commercial	$14,878.76
Rate for Payer: Three Rivers Preferred All Commercial	$19,432.67

MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC

Facility

$18,350.02

Service Code	MSDRG 803
Min. Negotiated Rate	$10,017.09
Max. Negotiated Rate	$18,350.02
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,557.20
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,350.02
Rate for Payer: Plain Church Group Ministry All Commercial	$10,017.09
Rate for Payer: Three Rivers Preferred All Commercial	$13,083.00

MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC

Facility

$36,955.70

Service Code	MSDRG 802
Min. Negotiated Rate	$20,173.75
Max. Negotiated Rate	$36,955.70
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$31,331.15
Rate for Payer: Anthem Blue Cross of IN Traditional	$36,955.70
Rate for Payer: Plain Church Group Ministry All Commercial	$20,173.75
Rate for Payer: Three Rivers Preferred All Commercial	$26,348.28

MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC

Facility

$11,397.63

Service Code	MSDRG 804
Min. Negotiated Rate	$6,221.85
Max. Negotiated Rate	$11,397.63
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,662.94
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,397.63
Rate for Payer: Plain Church Group Ministry All Commercial	$6,221.85
Rate for Payer: Three Rivers Preferred All Commercial	$8,126.16

MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC

Facility

$19,461.33

Service Code	MSDRG 205
Min. Negotiated Rate	$10,623.75
Max. Negotiated Rate	$19,461.33
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,499.37
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,461.33
Rate for Payer: Plain Church Group Ministry All Commercial	$10,623.75
Rate for Payer: Three Rivers Preferred All Commercial	$13,875.33

MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC

Facility

$9,337.89

Service Code	MSDRG 206
Min. Negotiated Rate	$5,097.46
Max. Negotiated Rate	$9,337.89
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,916.69
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,337.89
Rate for Payer: Plain Church Group Ministry All Commercial	$5,097.46
Rate for Payer: Three Rivers Preferred All Commercial	$6,657.63

MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC

Facility

$18,836.60

Service Code	MSDRG 167
Min. Negotiated Rate	$10,282.71
Max. Negotiated Rate	$18,836.60
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,969.73
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,836.60
Rate for Payer: Plain Church Group Ministry All Commercial	$10,282.71
Rate for Payer: Three Rivers Preferred All Commercial	$13,429.92

MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC

Facility

$39,692.74

Service Code	MSDRG 166
Min. Negotiated Rate	$21,667.87
Max. Negotiated Rate	$39,692.74
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$33,651.62
Rate for Payer: Anthem Blue Cross of IN Traditional	$39,692.74
Rate for Payer: Plain Church Group Ministry All Commercial	$21,667.87
Rate for Payer: Three Rivers Preferred All Commercial	$28,299.71

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

Facility

$13,957.36

Service Code	MSDRG 168
Min. Negotiated Rate	$7,619.18
Max. Negotiated Rate	$13,957.36
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,833.09
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,957.36
Rate for Payer: Plain Church Group Ministry All Commercial	$7,619.18
Rate for Payer: Three Rivers Preferred All Commercial	$9,951.17

MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC

Facility

$18,277.86

Service Code	MSDRG 580
Min. Negotiated Rate	$9,977.70
Max. Negotiated Rate	$18,277.86
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,496.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,277.86
Rate for Payer: Plain Church Group Ministry All Commercial	$9,977.70
Rate for Payer: Three Rivers Preferred All Commercial	$13,031.55

MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC

Facility

$33,601.15

Service Code	MSDRG 579
Min. Negotiated Rate	$18,342.53
Max. Negotiated Rate	$33,601.15
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$28,487.16
Rate for Payer: Anthem Blue Cross of IN Traditional	$33,601.15
Rate for Payer: Plain Church Group Ministry All Commercial	$18,342.53
Rate for Payer: Three Rivers Preferred All Commercial	$23,956.59

MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC

Facility

$14,836.71

Service Code	MSDRG 581
Min. Negotiated Rate	$8,099.21
Max. Negotiated Rate	$14,836.71
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,578.61
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,836.71
Rate for Payer: Plain Church Group Ministry All Commercial	$8,099.21
Rate for Payer: Three Rivers Preferred All Commercial	$10,578.12

MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH CC

Facility

$26,318.88

Service Code	MSDRG 253
Min. Negotiated Rate	$14,367.21
Max. Negotiated Rate	$26,318.88
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$22,313.22
Rate for Payer: Anthem Blue Cross of IN Traditional	$26,318.88
Rate for Payer: Plain Church Group Ministry All Commercial	$14,367.21
Rate for Payer: Three Rivers Preferred All Commercial	$18,764.55

MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH MCC

Facility

$35,363.99

Service Code	MSDRG 252
Min. Negotiated Rate	$19,304.85
Max. Negotiated Rate	$35,363.99
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$29,981.70
Rate for Payer: Anthem Blue Cross of IN Traditional	$35,363.99
Rate for Payer: Plain Church Group Ministry All Commercial	$19,304.85
Rate for Payer: Three Rivers Preferred All Commercial	$25,213.44

MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC

Facility

$18,034.56

Service Code	MSDRG 254
Min. Negotiated Rate	$9,844.89
Max. Negotiated Rate	$18,034.56
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,289.76
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,034.56
Rate for Payer: Plain Church Group Ministry All Commercial	$9,844.89
Rate for Payer: Three Rivers Preferred All Commercial	$12,858.09

MS-DRG 42.00: OTITIS MEDIA AND URI WITH MCC

Facility

$11,698.65

Service Code	MSDRG 152
Min. Negotiated Rate	$6,386.18
Max. Negotiated Rate	$11,698.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,918.15
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,698.65
Rate for Payer: Plain Church Group Ministry All Commercial	$6,386.18
Rate for Payer: Three Rivers Preferred All Commercial	$8,340.78

Know your out-of-pocket cost for care.

All Charges