Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT MSDRG 099: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC

Facility IP

$13,723.48

Service Code	MS-DRG 099
Hospital Charge Code	MSDRG 099
Min. Negotiated Rate	$7,870.17
Max. Negotiated Rate	$13,723.48
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$11,634.12
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,723.48
Rate for Payer: Plain Church Group Ministry All Commercial	$7,870.17
Rate for Payer: Three Rivers Preferred All Commercial	$10,278.98

INPATIENT MSDRG 100: SEIZURES WITH MCC

Facility IP

$18,850.77

Service Code	MS-DRG 100
Hospital Charge Code	MSDRG 100
Min. Negotiated Rate	$10,810.58
Max. Negotiated Rate	$18,850.77
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,980.80
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,850.77
Rate for Payer: Plain Church Group Ministry All Commercial	$10,810.58
Rate for Payer: Three Rivers Preferred All Commercial	$14,119.35

INPATIENT MSDRG 101: SEIZURES WITHOUT MCC

Facility IP

$8,846.42

Service Code	MS-DRG 101
Hospital Charge Code	MSDRG 101
Min. Negotiated Rate	$5,073.26
Max. Negotiated Rate	$8,846.42
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,499.58
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,846.42
Rate for Payer: Plain Church Group Ministry All Commercial	$5,073.26
Rate for Payer: Three Rivers Preferred All Commercial	$6,626.03

INPATIENT MSDRG 102: HEADACHES WITH MCC

Facility IP

$11,283.97

Service Code	MS-DRG 102
Hospital Charge Code	MSDRG 102
Min. Negotiated Rate	$6,471.15
Max. Negotiated Rate	$11,283.97
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$9,566.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,283.97
Rate for Payer: Plain Church Group Ministry All Commercial	$6,471.15
Rate for Payer: Three Rivers Preferred All Commercial	$8,451.77

INPATIENT MSDRG 103: HEADACHES WITHOUT MCC

Facility IP

$8,169.32

Service Code	MS-DRG 103
Hospital Charge Code	MSDRG 103
Min. Negotiated Rate	$4,684.96
Max. Negotiated Rate	$8,169.32
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,925.57
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,169.32
Rate for Payer: Plain Church Group Ministry All Commercial	$4,684.96
Rate for Payer: Three Rivers Preferred All Commercial	$6,118.88

INPATIENT MSDRG 113: ORBITAL PROCEDURES WITH CC/MCC

Facility IP

$22,033.13

Service Code	MS-DRG 113
Hospital Charge Code	MSDRG 113
Min. Negotiated Rate	$12,635.61
Max. Negotiated Rate	$22,033.13
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$18,678.65
Rate for Payer: Anthem Blue Cross of IN Traditional	$22,033.13
Rate for Payer: Plain Church Group Ministry All Commercial	$12,635.61
Rate for Payer: Three Rivers Preferred All Commercial	$16,502.96

INPATIENT MSDRG 114: ORBITAL PROCEDURES WITHOUT CC/MCC

Facility IP

$12,784.38

Service Code	MS-DRG 114
Hospital Charge Code	MSDRG 114
Min. Negotiated Rate	$7,331.61
Max. Negotiated Rate	$12,784.38
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$10,837.99
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,784.38
Rate for Payer: Plain Church Group Ministry All Commercial	$7,331.61
Rate for Payer: Three Rivers Preferred All Commercial	$9,575.58

INPATIENT MSDRG 115: EXTRAOCULAR PROCEDURES EXCEPT ORBIT

Facility IP

$14,906.93

Service Code	MS-DRG 115
Hospital Charge Code	MSDRG 115
Min. Negotiated Rate	$8,548.86
Max. Negotiated Rate	$14,906.93
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,637.39
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,906.93
Rate for Payer: Plain Church Group Ministry All Commercial	$8,548.86
Rate for Payer: Three Rivers Preferred All Commercial	$11,165.39

INPATIENT MSDRG 116: INTRAOCULAR PROCEDURES WITH CC/MCC

Facility IP

$18,512.22

Service Code	MS-DRG 116
Hospital Charge Code	MSDRG 116
Min. Negotiated Rate	$10,616.43
Max. Negotiated Rate	$18,512.22
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,693.79
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,512.22
Rate for Payer: Plain Church Group Ministry All Commercial	$10,616.43
Rate for Payer: Three Rivers Preferred All Commercial	$13,865.78

INPATIENT MSDRG 117: INTRAOCULAR PROCEDURES WITHOUT CC/MCC

Facility IP

$9,742.35

Service Code	MS-DRG 117
Hospital Charge Code	MSDRG 117
Min. Negotiated Rate	$5,587.06
Max. Negotiated Rate	$9,742.35
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$8,259.10
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,742.35
Rate for Payer: Plain Church Group Ministry All Commercial	$5,587.06
Rate for Payer: Three Rivers Preferred All Commercial	$7,297.08

INPATIENT MSDRG 121: ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility IP

$12,023.87

Service Code	MS-DRG 121
Hospital Charge Code	MSDRG 121
Min. Negotiated Rate	$6,895.47
Max. Negotiated Rate	$12,023.87
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$10,193.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,023.87
Rate for Payer: Plain Church Group Ministry All Commercial	$6,895.47
Rate for Payer: Three Rivers Preferred All Commercial	$9,005.96

INPATIENT MSDRG 122: ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility IP

$6,778.82

Service Code	MS-DRG 122
Hospital Charge Code	MSDRG 122
Min. Negotiated Rate	$3,887.53
Max. Negotiated Rate	$6,778.82
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$5,746.77
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,778.82
Rate for Payer: Plain Church Group Ministry All Commercial	$3,887.53
Rate for Payer: Three Rivers Preferred All Commercial	$5,077.38

INPATIENT MSDRG 123: NEUROLOGICAL EYE DISORDERS

Facility IP

$7,789.56

Service Code	MS-DRG 123
Hospital Charge Code	MSDRG 123
Min. Negotiated Rate	$4,467.17
Max. Negotiated Rate	$7,789.56
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,603.62
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,789.56
Rate for Payer: Plain Church Group Ministry All Commercial	$4,467.17
Rate for Payer: Three Rivers Preferred All Commercial	$5,834.43

INPATIENT MSDRG 124: OTHER DISORDERS OF THE EYE WITH MCC

Facility IP

$13,745.07

Service Code	MS-DRG 124
Hospital Charge Code	MSDRG 124
Min. Negotiated Rate	$7,882.55
Max. Negotiated Rate	$13,745.07
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$11,652.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,745.07
Rate for Payer: Plain Church Group Ministry All Commercial	$7,882.55
Rate for Payer: Three Rivers Preferred All Commercial	$10,295.15

INPATIENT MSDRG 125: OTHER DISORDERS OF THE EYE WITHOUT MCC

Facility IP

$8,459.79

Service Code	MS-DRG 125
Hospital Charge Code	MSDRG 125
Min. Negotiated Rate	$4,851.54
Max. Negotiated Rate	$8,459.79
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,171.81
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,459.79
Rate for Payer: Plain Church Group Ministry All Commercial	$4,851.54
Rate for Payer: Three Rivers Preferred All Commercial	$6,336.44

INPATIENT MSDRG 135: SINUS AND MASTOID PROCEDURES WITH CC/MCC

Facility IP

$24,048.72

Service Code	MS-DRG 135
Hospital Charge Code	MSDRG 135
Min. Negotiated Rate	$13,791.51
Max. Negotiated Rate	$24,048.72
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$20,387.37
Rate for Payer: Anthem Blue Cross of IN Traditional	$24,048.72
Rate for Payer: Plain Church Group Ministry All Commercial	$13,791.51
Rate for Payer: Three Rivers Preferred All Commercial	$18,012.65

INPATIENT MSDRG 136: SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC

Facility IP

$11,386.02

Service Code	MS-DRG 136
Hospital Charge Code	MSDRG 136
Min. Negotiated Rate	$6,529.68
Max. Negotiated Rate	$11,386.02
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$9,652.54
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,386.02
Rate for Payer: Plain Church Group Ministry All Commercial	$6,529.68
Rate for Payer: Three Rivers Preferred All Commercial	$8,528.21

INPATIENT MSDRG 137: MOUTH PROCEDURES WITH CC/MCC

Facility IP

$14,715.57

Service Code	MS-DRG 137
Hospital Charge Code	MSDRG 137
Min. Negotiated Rate	$8,439.12
Max. Negotiated Rate	$14,715.57
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,475.17
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,715.57
Rate for Payer: Plain Church Group Ministry All Commercial	$8,439.12
Rate for Payer: Three Rivers Preferred All Commercial	$11,022.06

INPATIENT MSDRG 138: MOUTH PROCEDURES WITHOUT CC/MCC

Facility IP

$8,677.64

Service Code	MS-DRG 138
Hospital Charge Code	MSDRG 138
Min. Negotiated Rate	$4,976.47
Max. Negotiated Rate	$8,677.64
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,356.49
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,677.64
Rate for Payer: Plain Church Group Ministry All Commercial	$4,976.47
Rate for Payer: Three Rivers Preferred All Commercial	$6,499.61

INPATIENT MSDRG 139: SALIVARY GLAND PROCEDURES

Facility IP

$12,339.85

Service Code	MS-DRG 139
Hospital Charge Code	MSDRG 139
Min. Negotiated Rate	$7,076.68
Max. Negotiated Rate	$12,339.85
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$10,461.14
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,339.85
Rate for Payer: Plain Church Group Ministry All Commercial	$7,076.68
Rate for Payer: Three Rivers Preferred All Commercial	$9,242.63

INPATIENT MSDRG 140: MAJOR HEAD AND NECK PROCEDURES WITH MCC

Facility IP

$40,785.77

Service Code	MS-DRG 140
Hospital Charge Code	MSDRG 140
Min. Negotiated Rate	$23,389.91
Max. Negotiated Rate	$40,785.77
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$34,576.26
Rate for Payer: Anthem Blue Cross of IN Traditional	$40,785.77
Rate for Payer: Plain Church Group Ministry All Commercial	$23,389.91
Rate for Payer: Three Rivers Preferred All Commercial	$30,548.81

INPATIENT MSDRG 141: MAJOR HEAD AND NECK PROCEDURES WITH CC

Facility IP

$21,908.50

Service Code	MS-DRG 141
Hospital Charge Code	MSDRG 141
Min. Negotiated Rate	$12,564.14
Max. Negotiated Rate	$21,908.50
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$18,573.00
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,908.50
Rate for Payer: Plain Church Group Ministry All Commercial	$12,564.14
Rate for Payer: Three Rivers Preferred All Commercial	$16,409.61

INPATIENT MSDRG 142: MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC

Facility IP

$16,698.78

Service Code	MS-DRG 142
Hospital Charge Code	MSDRG 142
Min. Negotiated Rate	$9,576.45
Max. Negotiated Rate	$16,698.78
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,156.44
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,698.78
Rate for Payer: Plain Church Group Ministry All Commercial	$9,576.45
Rate for Payer: Three Rivers Preferred All Commercial	$12,507.50

INPATIENT MSDRG 143: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC

Facility IP

$31,132.72

Service Code	MS-DRG 143
Hospital Charge Code	MSDRG 143
Min. Negotiated Rate	$17,854.06
Max. Negotiated Rate	$31,132.72
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$26,392.86
Rate for Payer: Anthem Blue Cross of IN Traditional	$31,132.72
Rate for Payer: Plain Church Group Ministry All Commercial	$17,854.06
Rate for Payer: Three Rivers Preferred All Commercial	$23,318.61

INPATIENT MSDRG 144: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC

Facility IP

$17,754.66

Service Code	MS-DRG 144
Hospital Charge Code	MSDRG 144
Min. Negotiated Rate	$10,181.98
Max. Negotiated Rate	$17,754.66
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,051.57
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,754.66
Rate for Payer: Plain Church Group Ministry All Commercial	$10,181.98
Rate for Payer: Three Rivers Preferred All Commercial	$13,298.36

Price Transparency.

All Charges