Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: OTITIS MEDIA AND URI WITHOUT MCC

Facility

$7,336.92

Service Code	MSDRG 153
Min. Negotiated Rate	$4,005.15
Max. Negotiated Rate	$7,336.92
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,220.26
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,336.92
Rate for Payer: Plain Church Group Ministry All Commercial	$4,005.15
Rate for Payer: Three Rivers Preferred All Commercial	$5,230.99

MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC

Facility

$28,951.80

Service Code	MSDRG 406
Min. Negotiated Rate	$15,804.50
Max. Negotiated Rate	$28,951.80
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$24,545.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$28,951.80
Rate for Payer: Plain Church Group Ministry All Commercial	$15,804.50
Rate for Payer: Three Rivers Preferred All Commercial	$20,641.74

MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC

Facility

$55,964.47

Service Code	MSDRG 405
Min. Negotiated Rate	$30,550.44
Max. Negotiated Rate	$55,964.47
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$47,446.84
Rate for Payer: Anthem Blue Cross of IN Traditional	$55,964.47
Rate for Payer: Plain Church Group Ministry All Commercial	$30,550.44
Rate for Payer: Three Rivers Preferred All Commercial	$39,900.94

MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$22,017.96

Service Code	MSDRG 407
Min. Negotiated Rate	$12,019.39
Max. Negotiated Rate	$22,017.96
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$18,666.89
Rate for Payer: Anthem Blue Cross of IN Traditional	$22,017.96
Rate for Payer: Plain Church Group Ministry All Commercial	$12,019.39
Rate for Payer: Three Rivers Preferred All Commercial	$15,698.13

MS-DRG 42.00: PANCREAS TRANSPLANT

Facility

$82,193.66

Service Code	MSDRG 010
Min. Negotiated Rate	$44,868.70
Max. Negotiated Rate	$82,193.66
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$69,684.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$82,193.66
Rate for Payer: Plain Church Group Ministry All Commercial	$44,868.70
Rate for Payer: Three Rivers Preferred All Commercial	$58,601.55

MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC

Facility

$10,936.82

Service Code	MSDRG 543
Min. Negotiated Rate	$5,970.30
Max. Negotiated Rate	$10,936.82
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,272.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,936.82
Rate for Payer: Plain Church Group Ministry All Commercial	$5,970.30
Rate for Payer: Three Rivers Preferred All Commercial	$7,797.61

MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC

Facility

$19,227.32

Service Code	MSDRG 542
Min. Negotiated Rate	$10,496.00
Max. Negotiated Rate	$19,227.32
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,300.97
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,227.32
Rate for Payer: Plain Church Group Ministry All Commercial	$10,496.00
Rate for Payer: Three Rivers Preferred All Commercial	$13,708.49

MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC

Facility

$7,790.51

Service Code	MSDRG 544
Min. Negotiated Rate	$4,252.76
Max. Negotiated Rate	$7,790.51
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,604.82
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,790.51
Rate for Payer: Plain Church Group Ministry All Commercial	$4,252.76
Rate for Payer: Three Rivers Preferred All Commercial	$5,554.40

MS-DRG 42.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC

Facility

$21,677.77

Service Code	MSDRG 734
Min. Negotiated Rate	$11,833.68
Max. Negotiated Rate	$21,677.77
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$18,378.47
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,677.77
Rate for Payer: Plain Church Group Ministry All Commercial	$11,833.68
Rate for Payer: Three Rivers Preferred All Commercial	$15,455.58

MS-DRG 42.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC

Facility

$12,514.10

Service Code	MSDRG 735
Min. Negotiated Rate	$6,831.32
Max. Negotiated Rate	$12,514.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,609.49
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,514.10
Rate for Payer: Plain Church Group Ministry All Commercial	$6,831.32
Rate for Payer: Three Rivers Preferred All Commercial	$8,922.17

MS-DRG 42.00: PENIS PROCEDURES WITH CC/MCC

Facility

$23,165.35

Service Code	MSDRG 709
Min. Negotiated Rate	$12,645.74
Max. Negotiated Rate	$23,165.35
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$19,639.65
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,165.35
Rate for Payer: Plain Church Group Ministry All Commercial	$12,645.74
Rate for Payer: Three Rivers Preferred All Commercial	$16,516.19

MS-DRG 42.00: PENIS PROCEDURES WITHOUT CC/MCC

Facility

$15,477.93

Service Code	MSDRG 710
Min. Negotiated Rate	$8,449.25
Max. Negotiated Rate	$15,477.93
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,122.24
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,477.93
Rate for Payer: Plain Church Group Ministry All Commercial	$8,449.25
Rate for Payer: Three Rivers Preferred All Commercial	$11,035.29

MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC

Facility

$40,311.28

Service Code	MSDRG 273
Min. Negotiated Rate	$22,005.53
Max. Negotiated Rate	$40,311.28
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$34,176.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$40,311.28
Rate for Payer: Plain Church Group Ministry All Commercial	$22,005.53
Rate for Payer: Three Rivers Preferred All Commercial	$28,740.71

MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC

Facility

$32,174.39

Service Code	MSDRG 274
Min. Negotiated Rate	$17,563.68
Max. Negotiated Rate	$32,174.39
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$27,277.54
Rate for Payer: Anthem Blue Cross of IN Traditional	$32,174.39
Rate for Payer: Plain Church Group Ministry All Commercial	$17,563.68
Rate for Payer: Three Rivers Preferred All Commercial	$22,939.35

MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES

Facility

$29,347.66

Service Code	MSDRG 321
Min. Negotiated Rate	$16,020.59
Max. Negotiated Rate	$29,347.66
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$24,881.03
Rate for Payer: Anthem Blue Cross of IN Traditional	$29,347.66
Rate for Payer: Plain Church Group Ministry All Commercial	$16,020.59
Rate for Payer: Three Rivers Preferred All Commercial	$20,923.98

MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC

Facility

$18,651.04

Service Code	MSDRG 322
Min. Negotiated Rate	$10,181.42
Max. Negotiated Rate	$18,651.04
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,812.41
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,651.04
Rate for Payer: Plain Church Group Ministry All Commercial	$10,181.42
Rate for Payer: Three Rivers Preferred All Commercial	$13,297.62

MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC

Facility

$23,840.59

Service Code	MSDRG 250
Min. Negotiated Rate	$13,014.34
Max. Negotiated Rate	$23,840.59
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$20,212.12
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,840.59
Rate for Payer: Plain Church Group Ministry All Commercial	$13,014.34
Rate for Payer: Three Rivers Preferred All Commercial	$16,997.61

MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC

Facility

$16,108.84

Service Code	MSDRG 251
Min. Negotiated Rate	$8,793.66
Max. Negotiated Rate	$16,108.84
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,657.12
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,108.84
Rate for Payer: Plain Church Group Ministry All Commercial	$8,793.66
Rate for Payer: Three Rivers Preferred All Commercial	$11,485.11

MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR

Facility

$23,279.78

Service Code	MSDRG 041
Min. Negotiated Rate	$12,708.20
Max. Negotiated Rate	$23,279.78
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$19,736.67
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,279.78
Rate for Payer: Plain Church Group Ministry All Commercial	$12,708.20
Rate for Payer: Three Rivers Preferred All Commercial	$16,597.77

MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC

Facility

$38,886.58

Service Code	MSDRG 040
Min. Negotiated Rate	$21,227.79
Max. Negotiated Rate	$38,886.58
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$32,968.15
Rate for Payer: Anthem Blue Cross of IN Traditional	$38,886.58
Rate for Payer: Plain Church Group Ministry All Commercial	$21,227.79
Rate for Payer: Three Rivers Preferred All Commercial	$27,724.94

MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC

Facility

$18,119.10

Service Code	MSDRG 042
Min. Negotiated Rate	$9,891.03
Max. Negotiated Rate	$18,119.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,361.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,119.10
Rate for Payer: Plain Church Group Ministry All Commercial	$9,891.03
Rate for Payer: Three Rivers Preferred All Commercial	$12,918.36

MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITH CC

Facility

$11,036.82

Service Code	MSDRG 300
Min. Negotiated Rate	$6,024.89
Max. Negotiated Rate	$11,036.82
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,357.04
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,036.82
Rate for Payer: Plain Church Group Ministry All Commercial	$6,024.89
Rate for Payer: Three Rivers Preferred All Commercial	$7,868.91

MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITH MCC

Facility

$16,675.84

Service Code	MSDRG 299
Min. Negotiated Rate	$9,103.17
Max. Negotiated Rate	$16,675.84
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,137.82
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,675.84
Rate for Payer: Plain Church Group Ministry All Commercial	$9,103.17
Rate for Payer: Three Rivers Preferred All Commercial	$11,889.36

MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC

Facility

$7,354.44

Service Code	MSDRG 301
Min. Negotiated Rate	$4,014.72
Max. Negotiated Rate	$7,354.44
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,235.12
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,354.44
Rate for Payer: Plain Church Group Ministry All Commercial	$4,014.72
Rate for Payer: Three Rivers Preferred All Commercial	$5,243.49

MS-DRG 42.00: PERITONEAL ADHESIOLYSIS WITH CC

Facility

$21,775.70

Service Code	MSDRG 336
Min. Negotiated Rate	$11,887.14
Max. Negotiated Rate	$21,775.70
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$18,461.50
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,775.70
Rate for Payer: Plain Church Group Ministry All Commercial	$11,887.14
Rate for Payer: Three Rivers Preferred All Commercial	$15,525.41

Know your out-of-pocket cost for care.

All Charges