Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT MSDRG 145: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC

Facility IP

$11,852.14

Service Code	MS-DRG 145
Hospital Charge Code	MSDRG 145
Min. Negotiated Rate	$6,796.99
Max. Negotiated Rate	$11,852.14
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$10,047.69
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,852.14
Rate for Payer: Plain Church Group Ministry All Commercial	$6,796.99
Rate for Payer: Three Rivers Preferred All Commercial	$8,877.33

INPATIENT MSDRG 146: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC

Facility IP

$19,765.34

Service Code	MS-DRG 146
Hospital Charge Code	MSDRG 146
Min. Negotiated Rate	$11,335.07
Max. Negotiated Rate	$19,765.34
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$16,756.13
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,765.34
Rate for Payer: Plain Church Group Ministry All Commercial	$11,335.07
Rate for Payer: Three Rivers Preferred All Commercial	$14,804.37

INPATIENT MSDRG 147: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC

Facility IP

$11,884.52

Service Code	MS-DRG 147
Hospital Charge Code	MSDRG 147
Min. Negotiated Rate	$6,815.56
Max. Negotiated Rate	$11,884.52
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$10,075.14
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,884.52
Rate for Payer: Plain Church Group Ministry All Commercial	$6,815.56
Rate for Payer: Three Rivers Preferred All Commercial	$8,901.59

INPATIENT MSDRG 148: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC

Facility IP

$8,023.11

Service Code	MS-DRG 148
Hospital Charge Code	MSDRG 148
Min. Negotiated Rate	$4,601.11
Max. Negotiated Rate	$8,023.11
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,801.61
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,023.11
Rate for Payer: Plain Church Group Ministry All Commercial	$4,601.11
Rate for Payer: Three Rivers Preferred All Commercial	$6,009.36

INPATIENT MSDRG 149: DYSEQUILIBRIUM

Facility IP

$7,408.82

Service Code	MS-DRG 149
Hospital Charge Code	MSDRG 149
Min. Negotiated Rate	$4,248.82
Max. Negotiated Rate	$7,408.82
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,280.85
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,408.82
Rate for Payer: Plain Church Group Ministry All Commercial	$4,248.82
Rate for Payer: Three Rivers Preferred All Commercial	$5,549.25

INPATIENT MSDRG 150: EPISTAXIS WITH MCC

Facility IP

$13,535.07

Service Code	MS-DRG 150
Hospital Charge Code	MSDRG 150
Min. Negotiated Rate	$7,762.12
Max. Negotiated Rate	$13,535.07
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$11,474.40
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,535.07
Rate for Payer: Plain Church Group Ministry All Commercial	$7,762.12
Rate for Payer: Three Rivers Preferred All Commercial	$10,137.86

INPATIENT MSDRG 151: EPISTAXIS WITHOUT MCC

Facility IP

$7,565.82

Service Code	MS-DRG 151
Hospital Charge Code	MSDRG 151
Min. Negotiated Rate	$4,338.86
Max. Negotiated Rate	$7,565.82
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,413.95
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,565.82
Rate for Payer: Plain Church Group Ministry All Commercial	$4,338.86
Rate for Payer: Three Rivers Preferred All Commercial	$5,666.85

INPATIENT MSDRG 152: OTITIS MEDIA AND URI WITH MCC

Facility IP

$11,753.03

Service Code	MS-DRG 152
Hospital Charge Code	MSDRG 152
Min. Negotiated Rate	$6,740.15
Max. Negotiated Rate	$11,753.03
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$9,963.67
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,753.03
Rate for Payer: Plain Church Group Ministry All Commercial	$6,740.15
Rate for Payer: Three Rivers Preferred All Commercial	$8,803.10

INPATIENT MSDRG 153: OTITIS MEDIA AND URI WITHOUT MCC

Facility IP

$6,775.88

Service Code	MS-DRG 153
Hospital Charge Code	MSDRG 153
Min. Negotiated Rate	$3,885.84
Max. Negotiated Rate	$6,775.88
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$5,744.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,775.88
Rate for Payer: Plain Church Group Ministry All Commercial	$3,885.84
Rate for Payer: Three Rivers Preferred All Commercial	$5,075.18

INPATIENT MSDRG 154: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC

Facility IP

$14,747.96

Service Code	MS-DRG 154
Hospital Charge Code	MSDRG 154
Min. Negotiated Rate	$8,457.69
Max. Negotiated Rate	$14,747.96
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,502.63
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,747.96
Rate for Payer: Plain Church Group Ministry All Commercial	$8,457.69
Rate for Payer: Three Rivers Preferred All Commercial	$11,046.32

INPATIENT MSDRG 155: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC

Facility IP

$9,021.09

Service Code	MS-DRG 155
Hospital Charge Code	MSDRG 155
Min. Negotiated Rate	$5,173.43
Max. Negotiated Rate	$9,021.09
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,647.66
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,021.09
Rate for Payer: Plain Church Group Ministry All Commercial	$5,173.43
Rate for Payer: Three Rivers Preferred All Commercial	$6,756.86

INPATIENT MSDRG 156: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC

Facility IP

$6,689.52

Service Code	MS-DRG 156
Hospital Charge Code	MSDRG 156
Min. Negotiated Rate	$3,836.32
Max. Negotiated Rate	$6,689.52
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$5,671.06
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,689.52
Rate for Payer: Plain Church Group Ministry All Commercial	$3,836.32
Rate for Payer: Three Rivers Preferred All Commercial	$5,010.50

INPATIENT MSDRG 157: DENTAL AND ORAL DISEASES WITH MCC

Facility IP

$16,405.37

Service Code	MS-DRG 157
Hospital Charge Code	MSDRG 157
Min. Negotiated Rate	$9,408.19
Max. Negotiated Rate	$16,405.37
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$13,907.70
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,405.37
Rate for Payer: Plain Church Group Ministry All Commercial	$9,408.19
Rate for Payer: Three Rivers Preferred All Commercial	$12,287.73

INPATIENT MSDRG 158: DENTAL AND ORAL DISEASES WITH CC

Facility IP

$9,117.26

Service Code	MS-DRG 158
Hospital Charge Code	MSDRG 158
Min. Negotiated Rate	$5,228.58
Max. Negotiated Rate	$9,117.26
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,729.18
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,117.26
Rate for Payer: Plain Church Group Ministry All Commercial	$5,228.58
Rate for Payer: Three Rivers Preferred All Commercial	$6,828.89

INPATIENT MSDRG 159: DENTAL AND ORAL DISEASES WITHOUT CC/MCC

Facility IP

$7,358.77

Service Code	MS-DRG 159
Hospital Charge Code	MSDRG 159
Min. Negotiated Rate	$4,220.12
Max. Negotiated Rate	$7,358.77
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,238.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,358.77
Rate for Payer: Plain Church Group Ministry All Commercial	$4,220.12
Rate for Payer: Three Rivers Preferred All Commercial	$5,511.77

INPATIENT MSDRG 163: MAJOR CHEST PROCEDURES WITH MCC

Facility IP

$47,531.23

Service Code	MS-DRG 163
Hospital Charge Code	MSDRG 163
Min. Negotiated Rate	$27,258.31
Max. Negotiated Rate	$47,531.23
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$40,294.74
Rate for Payer: Anthem Blue Cross of IN Traditional	$47,531.23
Rate for Payer: Plain Church Group Ministry All Commercial	$27,258.31
Rate for Payer: Three Rivers Preferred All Commercial	$35,601.20

INPATIENT MSDRG 164: MAJOR CHEST PROCEDURES WITH CC

Facility IP

$25,344.04

Service Code	MS-DRG 164
Hospital Charge Code	MSDRG 164
Min. Negotiated Rate	$14,534.35
Max. Negotiated Rate	$25,344.04
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$21,485.48
Rate for Payer: Anthem Blue Cross of IN Traditional	$25,344.04
Rate for Payer: Plain Church Group Ministry All Commercial	$14,534.35
Rate for Payer: Three Rivers Preferred All Commercial	$18,982.85

INPATIENT MSDRG 165: MAJOR CHEST PROCEDURES WITHOUT CC/MCC

Facility IP

$18,908.67

Service Code	MS-DRG 165
Hospital Charge Code	MSDRG 165
Min. Negotiated Rate	$10,843.78
Max. Negotiated Rate	$18,908.67
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$16,029.88
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,908.67
Rate for Payer: Plain Church Group Ministry All Commercial	$10,843.78
Rate for Payer: Three Rivers Preferred All Commercial	$14,162.72

INPATIENT MSDRG 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC

Facility IP

$35,972.50

Service Code	MS-DRG 166
Hospital Charge Code	MSDRG 166
Min. Negotiated Rate	$20,629.58
Max. Negotiated Rate	$35,972.50
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$30,495.79
Rate for Payer: Anthem Blue Cross of IN Traditional	$35,972.50
Rate for Payer: Plain Church Group Ministry All Commercial	$20,629.58
Rate for Payer: Three Rivers Preferred All Commercial	$26,943.63

INPATIENT MSDRG 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC

Facility IP

$18,655.49

Service Code	MS-DRG 167
Hospital Charge Code	MSDRG 167
Min. Negotiated Rate	$10,698.59
Max. Negotiated Rate	$18,655.49
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,815.25
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,655.49
Rate for Payer: Plain Church Group Ministry All Commercial	$10,698.59
Rate for Payer: Three Rivers Preferred All Commercial	$13,973.09

INPATIENT MSDRG 168: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility IP

$13,910.91

Service Code	MS-DRG 168
Hospital Charge Code	MSDRG 168
Min. Negotiated Rate	$7,977.66
Max. Negotiated Rate	$13,910.91
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$11,793.01
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,910.91
Rate for Payer: Plain Church Group Ministry All Commercial	$7,977.66
Rate for Payer: Three Rivers Preferred All Commercial	$10,419.36

INPATIENT MSDRG 175: PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE

Facility IP

$13,706.80

Service Code	MS-DRG 175
Hospital Charge Code	MSDRG 175
Min. Negotiated Rate	$7,860.60
Max. Negotiated Rate	$13,706.80
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$11,619.98
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,706.80
Rate for Payer: Plain Church Group Ministry All Commercial	$7,860.60
Rate for Payer: Three Rivers Preferred All Commercial	$10,266.48

INPATIENT MSDRG 176: PULMONARY EMBOLISM WITHOUT MCC

Facility IP

$8,023.11

Service Code	MS-DRG 176
Hospital Charge Code	MSDRG 176
Min. Negotiated Rate	$4,601.11
Max. Negotiated Rate	$8,023.11
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,801.61
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,023.11
Rate for Payer: Plain Church Group Ministry All Commercial	$4,601.11
Rate for Payer: Three Rivers Preferred All Commercial	$6,009.36

INPATIENT MSDRG 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC

Facility IP

$17,466.16

Service Code	MS-DRG 177
Hospital Charge Code	MSDRG 177
Min. Negotiated Rate	$10,016.53
Max. Negotiated Rate	$17,466.16
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,806.99
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,466.16
Rate for Payer: Plain Church Group Ministry All Commercial	$10,016.53
Rate for Payer: Three Rivers Preferred All Commercial	$13,082.27

INPATIENT MSDRG 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC

Facility IP

$10,666.73

Service Code	MS-DRG 178
Hospital Charge Code	MSDRG 178
Min. Negotiated Rate	$6,117.18
Max. Negotiated Rate	$10,666.73
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$9,042.75
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,666.73
Rate for Payer: Plain Church Group Ministry All Commercial	$6,117.18
Rate for Payer: Three Rivers Preferred All Commercial	$7,989.45

Price Transparency.

All Charges