Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC

Facility

$17,460.35

Service Code	MSDRG 256
Min. Negotiated Rate	$9,531.43
Max. Negotiated Rate	$17,460.35
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,802.94
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,460.35
Rate for Payer: Plain Church Group Ministry All Commercial	$9,531.43
Rate for Payer: Three Rivers Preferred All Commercial	$12,448.69

MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC

Facility

$26,973.50

Service Code	MSDRG 255
Min. Negotiated Rate	$14,724.56
Max. Negotiated Rate	$26,973.50
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$22,868.21
Rate for Payer: Anthem Blue Cross of IN Traditional	$26,973.50
Rate for Payer: Plain Church Group Ministry All Commercial	$14,724.56
Rate for Payer: Three Rivers Preferred All Commercial	$19,231.28

MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC

Facility

$9,194.60

Service Code	MSDRG 257
Min. Negotiated Rate	$5,019.24
Max. Negotiated Rate	$9,194.60
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$7,795.21
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,194.60
Rate for Payer: Plain Church Group Ministry All Commercial	$5,019.24
Rate for Payer: Three Rivers Preferred All Commercial	$6,555.47

MS-DRG 42.00: URETHRAL PROCEDURES WITH CC/MCC

Facility

$17,769.62

Service Code	MSDRG 671
Min. Negotiated Rate	$9,700.26
Max. Negotiated Rate	$17,769.62
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,065.14
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,769.62
Rate for Payer: Plain Church Group Ministry All Commercial	$9,700.26
Rate for Payer: Three Rivers Preferred All Commercial	$12,669.19

MS-DRG 42.00: URETHRAL PROCEDURES WITHOUT CC/MCC

Facility

$11,282.17

Service Code	MSDRG 672
Min. Negotiated Rate	$6,158.82
Max. Negotiated Rate	$11,282.17
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,565.06
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,282.17
Rate for Payer: Plain Church Group Ministry All Commercial	$6,158.82
Rate for Payer: Three Rivers Preferred All Commercial	$8,043.84

MS-DRG 42.00: URETHRAL STRICTURE

Facility

$10,327.56

Service Code	MSDRG 697
Min. Negotiated Rate	$5,637.71
Max. Negotiated Rate	$10,327.56
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,755.73
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,327.56
Rate for Payer: Plain Church Group Ministry All Commercial	$5,637.71
Rate for Payer: Three Rivers Preferred All Commercial	$7,363.23

MS-DRG 42.00: URINARY STONES WITH MCC

Facility

$15,158.35

Service Code	MSDRG 693
Min. Negotiated Rate	$8,274.79
Max. Negotiated Rate	$15,158.35
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,851.30
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,158.35
Rate for Payer: Plain Church Group Ministry All Commercial	$8,274.79
Rate for Payer: Three Rivers Preferred All Commercial	$10,807.44

MS-DRG 42.00: URINARY STONES WITHOUT MCC

Facility

$8,055.45

Service Code	MSDRG 694
Min. Negotiated Rate	$4,397.39
Max. Negotiated Rate	$8,055.45
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,829.44
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,055.45
Rate for Payer: Plain Church Group Ministry All Commercial	$4,397.39
Rate for Payer: Three Rivers Preferred All Commercial	$5,743.29

MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC

Facility

$18,831.45

Service Code	MSDRG 742
Min. Negotiated Rate	$10,279.90
Max. Negotiated Rate	$18,831.45
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,965.36
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,831.45
Rate for Payer: Plain Church Group Ministry All Commercial	$10,279.90
Rate for Payer: Three Rivers Preferred All Commercial	$13,426.25

MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC

Facility

$12,357.40

Service Code	MSDRG 743
Min. Negotiated Rate	$6,745.78
Max. Negotiated Rate	$12,357.40
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$10,476.64
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,357.40
Rate for Payer: Plain Church Group Ministry All Commercial	$6,745.78
Rate for Payer: Three Rivers Preferred All Commercial	$8,810.44

MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC

Facility

$18,744.85

Service Code	MSDRG 740
Min. Negotiated Rate	$10,232.63
Max. Negotiated Rate	$18,744.85
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$15,891.94
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,744.85
Rate for Payer: Plain Church Group Ministry All Commercial	$10,232.63
Rate for Payer: Three Rivers Preferred All Commercial	$13,364.50

MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC

Facility

$41,039.10

Service Code	MSDRG 739
Min. Negotiated Rate	$22,402.83
Max. Negotiated Rate	$41,039.10
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$34,793.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$41,039.10
Rate for Payer: Plain Church Group Ministry All Commercial	$22,402.83
Rate for Payer: Three Rivers Preferred All Commercial	$29,259.62

MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC

Facility

$14,160.44

Service Code	MSDRG 741
Min. Negotiated Rate	$7,730.04
Max. Negotiated Rate	$14,160.44
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$12,005.26
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,160.44
Rate for Payer: Plain Church Group Ministry All Commercial	$7,730.04
Rate for Payer: Three Rivers Preferred All Commercial	$10,095.96

MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC

Facility

$20,601.51

Service Code	MSDRG 737
Min. Negotiated Rate	$11,246.16
Max. Negotiated Rate	$20,601.51
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$17,466.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,601.51
Rate for Payer: Plain Church Group Ministry All Commercial	$11,246.16
Rate for Payer: Three Rivers Preferred All Commercial	$14,688.24

MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC

Facility

$40,592.72

Service Code	MSDRG 736
Min. Negotiated Rate	$22,159.16
Max. Negotiated Rate	$40,592.72
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$34,414.62
Rate for Payer: Anthem Blue Cross of IN Traditional	$40,592.72
Rate for Payer: Plain Church Group Ministry All Commercial	$22,159.16
Rate for Payer: Three Rivers Preferred All Commercial	$28,941.36

MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC

Facility

$15,637.72

Service Code	MSDRG 738
Min. Negotiated Rate	$8,536.48
Max. Negotiated Rate	$15,637.72
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$13,257.71
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,637.72
Rate for Payer: Plain Church Group Ministry All Commercial	$8,536.48
Rate for Payer: Three Rivers Preferred All Commercial	$11,149.22

MS-DRG 42.00: VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC

Facility

$17,263.45

Service Code	MSDRG 746
Min. Negotiated Rate	$9,423.95
Max. Negotiated Rate	$17,263.45
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$14,636.00
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,263.45
Rate for Payer: Plain Church Group Ministry All Commercial	$9,423.95
Rate for Payer: Three Rivers Preferred All Commercial	$12,308.31

MS-DRG 42.00: VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC

Facility

$9,847.16

Service Code	MSDRG 747
Min. Negotiated Rate	$5,375.46
Max. Negotiated Rate	$9,847.16
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,348.45
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,847.16
Rate for Payer: Plain Church Group Ministry All Commercial	$5,375.46
Rate for Payer: Three Rivers Preferred All Commercial	$7,020.72

MS-DRG 42.00: VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C

Facility

$11,301.76

Service Code	MSDRG 768
Min. Negotiated Rate	$6,169.52
Max. Negotiated Rate	$11,301.76
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$9,581.66
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,301.76
Rate for Payer: Plain Church Group Ministry All Commercial	$6,169.52
Rate for Payer: Three Rivers Preferred All Commercial	$8,057.81

MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC

Facility

$7,459.59

Service Code	MSDRG 806
Min. Negotiated Rate	$4,072.12
Max. Negotiated Rate	$7,459.59
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$6,324.26
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,459.59
Rate for Payer: Plain Church Group Ministry All Commercial	$4,072.12
Rate for Payer: Three Rivers Preferred All Commercial	$5,318.46

MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC

Facility

$10,288.38

Service Code	MSDRG 805
Min. Negotiated Rate	$5,616.32
Max. Negotiated Rate	$10,288.38
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,722.52
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,288.38
Rate for Payer: Plain Church Group Ministry All Commercial	$5,616.32
Rate for Payer: Three Rivers Preferred All Commercial	$7,335.30

MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

Facility

$6,569.93

Service Code	MSDRG 807
Min. Negotiated Rate	$3,586.46
Max. Negotiated Rate	$6,569.93
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$5,570.00
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,569.93
Rate for Payer: Plain Church Group Ministry All Commercial	$3,586.46
Rate for Payer: Three Rivers Preferred All Commercial	$4,684.15

MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC

Facility

$9,981.17

Service Code	MSDRG 797
Min. Negotiated Rate	$5,448.62
Max. Negotiated Rate	$9,981.17
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,462.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,981.17
Rate for Payer: Plain Church Group Ministry All Commercial	$5,448.62
Rate for Payer: Three Rivers Preferred All Commercial	$7,116.27

MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC

Facility

$13,160.47

Service Code	MSDRG 796
Min. Negotiated Rate	$7,184.17
Max. Negotiated Rate	$13,160.47
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$11,157.48
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,160.47
Rate for Payer: Plain Church Group Ministry All Commercial	$7,184.17
Rate for Payer: Three Rivers Preferred All Commercial	$9,383.01

MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC

Facility

$9,981.17

Service Code	MSDRG 798
Min. Negotiated Rate	$5,448.62
Max. Negotiated Rate	$9,981.17
Rate for Payer: Anthem Blue Cross of IN PPO/Pathway	$8,462.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,981.17
Rate for Payer: Plain Church Group Ministry All Commercial	$5,448.62
Rate for Payer: Three Rivers Preferred All Commercial	$7,116.27

Know your out-of-pocket cost for care.

All Charges