Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC

Facility

$21,550.96

Service Code	MSDRG 814
Min. Negotiated Rate	$11,764.46
Max. Negotiated Rate	$21,550.96
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$18,270.97
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,550.96
Rate for Payer: Plain Church Group Ministry All Commercial	$11,764.46
Rate for Payer: Three Rivers Preferred All Commercial	$15,365.17

MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC

Facility

$6,797.75

Service Code	MSDRG 816
Min. Negotiated Rate	$3,710.83
Max. Negotiated Rate	$6,797.75
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,763.16
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,797.75
Rate for Payer: Plain Church Group Ministry All Commercial	$3,710.83
Rate for Payer: Three Rivers Preferred All Commercial	$4,846.59

MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH CC

Facility

$35,310.39

Service Code	MSDRG 467
Min. Negotiated Rate	$19,275.59
Max. Negotiated Rate	$35,310.39
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$29,936.25
Rate for Payer: Anthem Blue Cross of IN Traditional	$35,310.39
Rate for Payer: Plain Church Group Ministry All Commercial	$19,275.59
Rate for Payer: Three Rivers Preferred All Commercial	$25,175.22

MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC

Facility

$52,520.23

Service Code	MSDRG 466
Min. Negotiated Rate	$28,670.27
Max. Negotiated Rate	$52,520.23
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$44,526.80
Rate for Payer: Anthem Blue Cross of IN Traditional	$52,520.23
Rate for Payer: Plain Church Group Ministry All Commercial	$28,670.27
Rate for Payer: Three Rivers Preferred All Commercial	$37,445.31

MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC

Facility

$27,043.60

Service Code	MSDRG 468
Min. Negotiated Rate	$14,762.83
Max. Negotiated Rate	$27,043.60
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$22,927.64
Rate for Payer: Anthem Blue Cross of IN Traditional	$27,043.60
Rate for Payer: Plain Church Group Ministry All Commercial	$14,762.83
Rate for Payer: Three Rivers Preferred All Commercial	$19,281.26

MS-DRG 42.00: SALIVARY GLAND PROCEDURES

Facility

$14,154.26

Service Code	MSDRG 139
Min. Negotiated Rate	$7,726.67
Max. Negotiated Rate	$14,154.26
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,000.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,154.26
Rate for Payer: Plain Church Group Ministry All Commercial	$7,726.67
Rate for Payer: Three Rivers Preferred All Commercial	$10,091.55

MS-DRG 42.00: SEIZURES WITH MCC

Facility

$20,466.46

Service Code	MSDRG 100
Min. Negotiated Rate	$11,172.43
Max. Negotiated Rate	$20,466.46
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,351.52
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,466.46
Rate for Payer: Plain Church Group Ministry All Commercial	$11,172.43
Rate for Payer: Three Rivers Preferred All Commercial	$14,591.95

MS-DRG 42.00: SEIZURES WITHOUT MCC

Facility

$9,501.81

Service Code	MSDRG 101
Min. Negotiated Rate	$5,186.94
Max. Negotiated Rate	$9,501.81
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,055.66
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,501.81
Rate for Payer: Plain Church Group Ministry All Commercial	$5,186.94
Rate for Payer: Three Rivers Preferred All Commercial	$6,774.49

MS-DRG 42.00: SEPTIC ARTHRITIS WITH CC

Facility

$12,423.38

Service Code	MSDRG 549
Min. Negotiated Rate	$6,781.80
Max. Negotiated Rate	$12,423.38
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,532.57
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,423.38
Rate for Payer: Plain Church Group Ministry All Commercial	$6,781.80
Rate for Payer: Three Rivers Preferred All Commercial	$8,857.49

MS-DRG 42.00: SEPTIC ARTHRITIS WITH MCC

Facility

$20,768.51

Service Code	MSDRG 548
Min. Negotiated Rate	$11,337.32
Max. Negotiated Rate	$20,768.51
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,607.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,768.51
Rate for Payer: Plain Church Group Ministry All Commercial	$11,337.32
Rate for Payer: Three Rivers Preferred All Commercial	$14,807.31

MS-DRG 42.00: SEPTIC ARTHRITIS WITHOUT CC/MCC

Facility

$8,887.39

Service Code	MSDRG 550
Min. Negotiated Rate	$4,851.54
Max. Negotiated Rate	$8,887.39
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,534.75
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,887.39
Rate for Payer: Plain Church Group Ministry All Commercial	$4,851.54
Rate for Payer: Three Rivers Preferred All Commercial	$6,336.44

MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS

Facility

$71,714.56

Service Code	MSDRG 870
Min. Negotiated Rate	$39,148.26
Max. Negotiated Rate	$71,714.56
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$60,799.81
Rate for Payer: Anthem Blue Cross of IN Traditional	$71,714.56
Rate for Payer: Plain Church Group Ministry All Commercial	$39,148.26
Rate for Payer: Three Rivers Preferred All Commercial	$51,130.28

MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC

Facility

$20,227.29

Service Code	MSDRG 871
Min. Negotiated Rate	$11,041.87
Max. Negotiated Rate	$20,227.29
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,148.75
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,227.29
Rate for Payer: Plain Church Group Ministry All Commercial	$11,041.87
Rate for Payer: Three Rivers Preferred All Commercial	$14,421.43

MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC

Facility

$10,628.58

Service Code	MSDRG 872
Min. Negotiated Rate	$5,802.03
Max. Negotiated Rate	$10,628.58
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,010.94
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,628.58
Rate for Payer: Plain Church Group Ministry All Commercial	$5,802.03
Rate for Payer: Three Rivers Preferred All Commercial	$7,577.85

MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC

Facility

$20,218.01

Service Code	MSDRG 511
Min. Negotiated Rate	$11,036.81
Max. Negotiated Rate	$20,218.01
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,140.89
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,218.01
Rate for Payer: Plain Church Group Ministry All Commercial	$11,036.81
Rate for Payer: Three Rivers Preferred All Commercial	$14,414.82

MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC

Facility

$29,464.15

Service Code	MSDRG 510
Min. Negotiated Rate	$16,084.19
Max. Negotiated Rate	$29,464.15
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$24,979.79
Rate for Payer: Anthem Blue Cross of IN Traditional	$29,464.15
Rate for Payer: Plain Church Group Ministry All Commercial	$16,084.19
Rate for Payer: Three Rivers Preferred All Commercial	$21,007.03

MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC

Facility

$16,574.81

Service Code	MSDRG 512
Min. Negotiated Rate	$9,048.02
Max. Negotiated Rate	$16,574.81
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,052.17
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,574.81
Rate for Payer: Plain Church Group Ministry All Commercial	$9,048.02
Rate for Payer: Three Rivers Preferred All Commercial	$11,817.33

MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$13,882.10

Service Code	MSDRG 555
Min. Negotiated Rate	$7,578.10
Max. Negotiated Rate	$13,882.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,769.28
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,882.10
Rate for Payer: Plain Church Group Ministry All Commercial	$7,578.10
Rate for Payer: Three Rivers Preferred All Commercial	$9,897.51

MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC

Facility

$8,417.30

Service Code	MSDRG 556
Min. Negotiated Rate	$4,594.92
Max. Negotiated Rate	$8,417.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,136.21
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,417.30
Rate for Payer: Plain Church Group Ministry All Commercial	$4,594.92
Rate for Payer: Three Rivers Preferred All Commercial	$6,001.27

MS-DRG 42.00: SIGNS AND SYMPTOMS WITH MCC

Facility

$13,259.44

Service Code	MSDRG 947
Min. Negotiated Rate	$7,238.19
Max. Negotiated Rate	$13,259.44
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,241.39
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,259.44
Rate for Payer: Plain Church Group Ministry All Commercial	$7,238.19
Rate for Payer: Three Rivers Preferred All Commercial	$9,453.57

MS-DRG 42.00: SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$8,190.50

Service Code	MSDRG 948
Min. Negotiated Rate	$4,471.11
Max. Negotiated Rate	$8,190.50
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,943.93
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,190.50
Rate for Payer: Plain Church Group Ministry All Commercial	$4,471.11
Rate for Payer: Three Rivers Preferred All Commercial	$5,839.57

MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH CC

Facility

$8,453.38

Service Code	MSDRG 194
Min. Negotiated Rate	$4,614.62
Max. Negotiated Rate	$8,453.38
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,166.80
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,453.38
Rate for Payer: Plain Church Group Ministry All Commercial	$4,614.62
Rate for Payer: Three Rivers Preferred All Commercial	$6,027.00

MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH MCC

Facility

$13,584.17

Service Code	MSDRG 193
Min. Negotiated Rate	$7,415.46
Max. Negotiated Rate	$13,584.17
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,516.70
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,584.17
Rate for Payer: Plain Church Group Ministry All Commercial	$7,415.46
Rate for Payer: Three Rivers Preferred All Commercial	$9,685.09

MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC

Facility

$6,419.41

Service Code	MSDRG 195
Min. Negotiated Rate	$3,504.29
Max. Negotiated Rate	$6,419.41
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,442.40
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,419.41
Rate for Payer: Plain Church Group Ministry All Commercial	$3,504.29
Rate for Payer: Three Rivers Preferred All Commercial	$4,576.85

MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT

Facility

$56,092.30

Service Code	MSDRG 008
Min. Negotiated Rate	$30,620.23
Max. Negotiated Rate	$56,092.30
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$47,555.21
Rate for Payer: Anthem Blue Cross of IN Traditional	$56,092.30
Rate for Payer: Plain Church Group Ministry All Commercial	$30,620.23
Rate for Payer: Three Rivers Preferred All Commercial	$39,992.08

Know your out-of-pocket cost for care.

All Charges