Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS

Facility

$81,722.54

Service Code	MSDRG 019
Min. Negotiated Rate	$44,611.51
Max. Negotiated Rate	$81,722.54
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$69,284.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$81,722.54
Rate for Payer: Plain Church Group Ministry All Commercial	$44,611.51
Rate for Payer: Three Rivers Preferred All Commercial	$58,265.65

MS-DRG 42.00: SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL

Facility

$40,330.87

Service Code	MSDRG 402
Min. Negotiated Rate	$22,016.22
Max. Negotiated Rate	$40,330.87
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$34,192.63
Rate for Payer: Anthem Blue Cross of IN Traditional	$40,330.87
Rate for Payer: Plain Church Group Ministry All Commercial	$22,016.22
Rate for Payer: Three Rivers Preferred All Commercial	$28,754.67

MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE

Facility

$53,092.38

Service Code	MSDRG 450
Min. Negotiated Rate	$28,982.60
Max. Negotiated Rate	$53,092.38
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$45,011.87
Rate for Payer: Anthem Blue Cross of IN Traditional	$53,092.38
Rate for Payer: Plain Church Group Ministry All Commercial	$28,982.60
Rate for Payer: Three Rivers Preferred All Commercial	$37,853.24

MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC

Facility

$31,813.57

Service Code	MSDRG 451
Min. Negotiated Rate	$17,366.71
Max. Negotiated Rate	$31,813.57
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$26,971.64
Rate for Payer: Anthem Blue Cross of IN Traditional	$31,813.57
Rate for Payer: Plain Church Group Ministry All Commercial	$17,366.71
Rate for Payer: Three Rivers Preferred All Commercial	$22,682.10

MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITH CC/MCC

Facility

$24,856.03

Service Code	MSDRG 135
Min. Negotiated Rate	$13,568.66
Max. Negotiated Rate	$24,856.03
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$21,073.01
Rate for Payer: Anthem Blue Cross of IN Traditional	$24,856.03
Rate for Payer: Plain Church Group Ministry All Commercial	$13,568.66
Rate for Payer: Three Rivers Preferred All Commercial	$17,721.58

MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC

Facility

$10,084.26

Service Code	MSDRG 136
Min. Negotiated Rate	$5,504.90
Max. Negotiated Rate	$10,084.26
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,549.47
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,084.26
Rate for Payer: Plain Church Group Ministry All Commercial	$5,504.90
Rate for Payer: Three Rivers Preferred All Commercial	$7,189.77

MS-DRG 42.00: SKIN DEBRIDEMENT WITH CC

Facility

$17,260.36

Service Code	MSDRG 571
Min. Negotiated Rate	$9,422.26
Max. Negotiated Rate	$17,260.36
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,633.38
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,260.36
Rate for Payer: Plain Church Group Ministry All Commercial	$9,422.26
Rate for Payer: Three Rivers Preferred All Commercial	$12,306.10

MS-DRG 42.00: SKIN DEBRIDEMENT WITH MCC

Facility

$31,032.15

Service Code	MSDRG 570
Min. Negotiated Rate	$16,940.14
Max. Negotiated Rate	$31,032.15
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$26,309.15
Rate for Payer: Anthem Blue Cross of IN Traditional	$31,032.15
Rate for Payer: Plain Church Group Ministry All Commercial	$16,940.14
Rate for Payer: Three Rivers Preferred All Commercial	$22,124.97

MS-DRG 42.00: SKIN DEBRIDEMENT WITHOUT CC/MCC

Facility

$11,777.00

Service Code	MSDRG 572
Min. Negotiated Rate	$6,428.95
Max. Negotiated Rate	$11,777.00
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,984.58
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,777.00
Rate for Payer: Plain Church Group Ministry All Commercial	$6,428.95
Rate for Payer: Three Rivers Preferred All Commercial	$8,396.64

MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC

Facility

$27,450.81

Service Code	MSDRG 577
Min. Negotiated Rate	$14,985.12
Max. Negotiated Rate	$27,450.81
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$23,272.87
Rate for Payer: Anthem Blue Cross of IN Traditional	$27,450.81
Rate for Payer: Plain Church Group Ministry All Commercial	$14,985.12
Rate for Payer: Three Rivers Preferred All Commercial	$19,571.58

MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC

Facility

$55,620.15

Service Code	MSDRG 576
Min. Negotiated Rate	$30,362.48
Max. Negotiated Rate	$55,620.15
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$47,154.92
Rate for Payer: Anthem Blue Cross of IN Traditional	$55,620.15
Rate for Payer: Plain Church Group Ministry All Commercial	$30,362.48
Rate for Payer: Three Rivers Preferred All Commercial	$39,655.46

MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility

$17,426.33

Service Code	MSDRG 578
Min. Negotiated Rate	$9,512.86
Max. Negotiated Rate	$17,426.33
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,774.10
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,426.33
Rate for Payer: Plain Church Group Ministry All Commercial	$9,512.86
Rate for Payer: Three Rivers Preferred All Commercial	$12,424.44

MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC

Facility

$35,719.65

Service Code	MSDRG 574
Min. Negotiated Rate	$19,499.00
Max. Negotiated Rate	$35,719.65
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$30,283.23
Rate for Payer: Anthem Blue Cross of IN Traditional	$35,719.65
Rate for Payer: Plain Church Group Ministry All Commercial	$19,499.00
Rate for Payer: Three Rivers Preferred All Commercial	$25,467.01

MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC

Facility

$63,484.88

Service Code	MSDRG 573
Min. Negotiated Rate	$34,655.76
Max. Negotiated Rate	$63,484.88
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$53,822.67
Rate for Payer: Anthem Blue Cross of IN Traditional	$63,484.88
Rate for Payer: Plain Church Group Ministry All Commercial	$34,655.76
Rate for Payer: Three Rivers Preferred All Commercial	$45,262.77

MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility

$20,583.98

Service Code	MSDRG 575
Min. Negotiated Rate	$11,236.59
Max. Negotiated Rate	$20,583.98
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,451.16
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,583.98
Rate for Payer: Plain Church Group Ministry All Commercial	$11,236.59
Rate for Payer: Three Rivers Preferred All Commercial	$14,675.75

MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC

Facility

$19,719.06

Service Code	MSDRG 623
Min. Negotiated Rate	$10,764.44
Max. Negotiated Rate	$19,719.06
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$16,717.87
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,719.06
Rate for Payer: Plain Church Group Ministry All Commercial	$10,764.44
Rate for Payer: Three Rivers Preferred All Commercial	$14,059.08

MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC

Facility

$38,576.28

Service Code	MSDRG 622
Min. Negotiated Rate	$21,058.40
Max. Negotiated Rate	$38,576.28
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$32,705.08
Rate for Payer: Anthem Blue Cross of IN Traditional	$38,576.28
Rate for Payer: Plain Church Group Ministry All Commercial	$21,058.40
Rate for Payer: Three Rivers Preferred All Commercial	$27,503.70

MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC

Facility

$10,340.96

Service Code	MSDRG 624
Min. Negotiated Rate	$5,645.03
Max. Negotiated Rate	$10,340.96
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,767.09
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,340.96
Rate for Payer: Plain Church Group Ministry All Commercial	$5,645.03
Rate for Payer: Three Rivers Preferred All Commercial	$7,372.78

MS-DRG 42.00: SKIN GRAFTS FOR INJURIES WITH CC/MCC

Facility

$39,804.08

Service Code	MSDRG 904
Min. Negotiated Rate	$21,728.65
Max. Negotiated Rate	$39,804.08
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$33,746.01
Rate for Payer: Anthem Blue Cross of IN Traditional	$39,804.08
Rate for Payer: Plain Church Group Ministry All Commercial	$21,728.65
Rate for Payer: Three Rivers Preferred All Commercial	$28,379.08

MS-DRG 42.00: SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC

Facility

$16,991.29

Service Code	MSDRG 905
Min. Negotiated Rate	$9,275.38
Max. Negotiated Rate	$16,991.29
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,405.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,991.29
Rate for Payer: Plain Church Group Ministry All Commercial	$9,275.38
Rate for Payer: Three Rivers Preferred All Commercial	$12,114.27

MS-DRG 42.00: SKIN ULCERS WITH CC

Facility

$12,604.81

Service Code	MSDRG 593
Min. Negotiated Rate	$6,880.84
Max. Negotiated Rate	$12,604.81
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,686.40
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,604.81
Rate for Payer: Plain Church Group Ministry All Commercial	$6,880.84
Rate for Payer: Three Rivers Preferred All Commercial	$8,986.84

MS-DRG 42.00: SKIN ULCERS WITH MCC

Facility

$21,198.40

Service Code	MSDRG 592
Min. Negotiated Rate	$11,571.99
Max. Negotiated Rate	$21,198.40
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,972.06
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,198.40
Rate for Payer: Plain Church Group Ministry All Commercial	$11,571.99
Rate for Payer: Three Rivers Preferred All Commercial	$15,113.81

MS-DRG 42.00: SKIN ULCERS WITHOUT CC/MCC

Facility

$8,749.25

Service Code	MSDRG 594
Min. Negotiated Rate	$4,776.13
Max. Negotiated Rate	$8,749.25
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,417.64
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,749.25
Rate for Payer: Plain Church Group Ministry All Commercial	$4,776.13
Rate for Payer: Three Rivers Preferred All Commercial	$6,237.94

MS-DRG 42.00: SOFT TISSUE PROCEDURES WITH CC

Facility

$18,398.47

Service Code	MSDRG 501
Min. Negotiated Rate	$10,043.54
Max. Negotiated Rate	$18,398.47
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,598.28
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,398.47
Rate for Payer: Plain Church Group Ministry All Commercial	$10,043.54
Rate for Payer: Three Rivers Preferred All Commercial	$13,117.55

MS-DRG 42.00: SOFT TISSUE PROCEDURES WITH MCC

Facility

$32,666.13

Service Code	MSDRG 500
Min. Negotiated Rate	$17,832.11
Max. Negotiated Rate	$32,666.13
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$27,694.44
Rate for Payer: Anthem Blue Cross of IN Traditional	$32,666.13
Rate for Payer: Plain Church Group Ministry All Commercial	$17,832.11
Rate for Payer: Three Rivers Preferred All Commercial	$23,289.94

Know your out-of-pocket cost for care.

All Charges