Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT MSDRG 236: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC

Facility IP

$40,021.34

Service Code	MS-DRG 236
Hospital Charge Code	MSDRG 236
Min. Negotiated Rate	$22,951.52
Max. Negotiated Rate	$40,021.34
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$33,928.21
Rate for Payer: Anthem Blue Cross of IN Traditional	$40,021.34
Rate for Payer: Plain Church Group Ministry All Commercial	$22,951.52
Rate for Payer: Three Rivers Preferred All Commercial	$29,976.24

INPATIENT MSDRG 239: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC

Facility IP

$45,631.43

Service Code	MS-DRG 239
Hospital Charge Code	MSDRG 239
Min. Negotiated Rate	$26,168.81
Max. Negotiated Rate	$45,631.43
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$38,684.18
Rate for Payer: Anthem Blue Cross of IN Traditional	$45,631.43
Rate for Payer: Plain Church Group Ministry All Commercial	$26,168.81
Rate for Payer: Three Rivers Preferred All Commercial	$34,178.24

INPATIENT MSDRG 240: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC

Facility IP

$26,634.44

Service Code	MS-DRG 240
Hospital Charge Code	MSDRG 240
Min. Negotiated Rate	$15,274.38
Max. Negotiated Rate	$26,634.44
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$22,579.43
Rate for Payer: Anthem Blue Cross of IN Traditional	$26,634.44
Rate for Payer: Plain Church Group Ministry All Commercial	$15,274.38
Rate for Payer: Three Rivers Preferred All Commercial	$19,949.37

INPATIENT MSDRG 241: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC

Facility IP

$15,199.36

Service Code	MS-DRG 241
Hospital Charge Code	MSDRG 241
Min. Negotiated Rate	$8,716.56
Max. Negotiated Rate	$15,199.36
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,885.30
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,199.36
Rate for Payer: Plain Church Group Ministry All Commercial	$8,716.56
Rate for Payer: Three Rivers Preferred All Commercial	$11,384.42

INPATIENT MSDRG 242: PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC

Facility IP

$34,085.46

Service Code	MS-DRG 242
Hospital Charge Code	MSDRG 242
Min. Negotiated Rate	$19,547.40
Max. Negotiated Rate	$34,085.46
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$28,896.05
Rate for Payer: Anthem Blue Cross of IN Traditional	$34,085.46
Rate for Payer: Plain Church Group Ministry All Commercial	$19,547.40
Rate for Payer: Three Rivers Preferred All Commercial	$25,530.23

INPATIENT MSDRG 243: PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC

Facility IP

$23,001.67

Service Code	MS-DRG 243
Hospital Charge Code	MSDRG 243
Min. Negotiated Rate	$13,191.05
Max. Negotiated Rate	$23,001.67
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$19,499.74
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,001.67
Rate for Payer: Plain Church Group Ministry All Commercial	$13,191.05
Rate for Payer: Three Rivers Preferred All Commercial	$17,228.40

INPATIENT MSDRG 244: PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC

Facility IP

$18,655.49

Service Code	MS-DRG 244
Hospital Charge Code	MSDRG 244
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 245: AICD GENERATOR PROCEDURES

Facility IP

$47,848.19

Service Code	MS-DRG 245
Hospital Charge Code	MSDRG 245
Min. Negotiated Rate	$27,440.08
Max. Negotiated Rate	$47,848.19
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$40,563.44
Rate for Payer: Anthem Blue Cross of IN Traditional	$47,848.19
Rate for Payer: Plain Church Group Ministry All Commercial	$27,440.08
Rate for Payer: Three Rivers Preferred All Commercial	$35,838.60

INPATIENT MSDRG 246: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS

Facility IP

$29,393.86

Service Code	MS-DRG 246
Hospital Charge Code	MSDRG 246
Min. Negotiated Rate	$16,856.85
Max. Negotiated Rate	$29,393.86
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$24,918.73
Rate for Payer: Anthem Blue Cross of IN Traditional	$29,393.86
Rate for Payer: Plain Church Group Ministry All Commercial	$16,856.85
Rate for Payer: Three Rivers Preferred All Commercial	$22,016.19

INPATIENT MSDRG 247: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC

Facility IP

$18,737.92

Service Code	MS-DRG 247
Hospital Charge Code	MSDRG 247
Min. Negotiated Rate	$10,745.86
Max. Negotiated Rate	$18,737.92
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,885.13
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,737.92
Rate for Payer: Plain Church Group Ministry All Commercial	$10,745.86
Rate for Payer: Three Rivers Preferred All Commercial	$14,034.83

INPATIENT MSDRG 248: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS

Facility IP

$29,535.17

Service Code	MS-DRG 248
Hospital Charge Code	MSDRG 248
Min. Negotiated Rate	$16,937.89
Max. Negotiated Rate	$29,535.17
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$25,038.53
Rate for Payer: Anthem Blue Cross of IN Traditional	$29,535.17
Rate for Payer: Plain Church Group Ministry All Commercial	$16,937.89
Rate for Payer: Three Rivers Preferred All Commercial	$22,122.03

INPATIENT MSDRG 249: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC

Facility IP

$17,827.28

Service Code	MS-DRG 249
Hospital Charge Code	MSDRG 249
Min. Negotiated Rate	$10,223.62
Max. Negotiated Rate	$17,827.28
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,113.13
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,827.28
Rate for Payer: Plain Church Group Ministry All Commercial	$10,223.62
Rate for Payer: Three Rivers Preferred All Commercial	$13,352.75

INPATIENT MSDRG 250: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITH MCC

Facility IP

$23,744.52

Service Code	MS-DRG 250
Hospital Charge Code	MSDRG 250
Min. Negotiated Rate	$13,617.06
Max. Negotiated Rate	$23,744.52
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$20,129.48
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,744.52
Rate for Payer: Plain Church Group Ministry All Commercial	$13,617.06
Rate for Payer: Three Rivers Preferred All Commercial	$17,784.80

INPATIENT MSDRG 251: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITHOUT MCC

Facility IP

$15,949.07

Service Code	MS-DRG 251
Hospital Charge Code	MSDRG 251
Min. Negotiated Rate	$9,146.51
Max. Negotiated Rate	$15,949.07
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$13,520.87
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,949.07
Rate for Payer: Plain Church Group Ministry All Commercial	$9,146.51
Rate for Payer: Three Rivers Preferred All Commercial	$11,945.96

INPATIENT MSDRG 252: OTHER VASCULAR PROCEDURES WITH MCC

Facility IP

$32,807.80

Service Code	MS-DRG 252
Hospital Charge Code	MSDRG 252
Min. Negotiated Rate	$18,814.69
Max. Negotiated Rate	$32,807.80
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$27,812.91
Rate for Payer: Anthem Blue Cross of IN Traditional	$32,807.80
Rate for Payer: Plain Church Group Ministry All Commercial	$18,814.69
Rate for Payer: Three Rivers Preferred All Commercial	$24,573.26

INPATIENT MSDRG 253: OTHER VASCULAR PROCEDURES WITH CC

Facility IP

$26,239.96

Service Code	MS-DRG 253
Hospital Charge Code	MSDRG 253
Min. Negotiated Rate	$15,048.15
Max. Negotiated Rate	$26,239.96
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$22,245.01
Rate for Payer: Anthem Blue Cross of IN Traditional	$26,239.96
Rate for Payer: Plain Church Group Ministry All Commercial	$15,048.15
Rate for Payer: Three Rivers Preferred All Commercial	$19,653.90

INPATIENT MSDRG 254: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC

Facility IP

$17,943.07

Service Code	MS-DRG 254
Hospital Charge Code	MSDRG 254
Min. Negotiated Rate	$10,290.03
Max. Negotiated Rate	$17,943.07
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,211.29
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,943.07
Rate for Payer: Plain Church Group Ministry All Commercial	$10,290.03
Rate for Payer: Three Rivers Preferred All Commercial	$13,439.48

INPATIENT MSDRG 255: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC

Facility IP

$25,176.23

Service Code	MS-DRG 255
Hospital Charge Code	MSDRG 255
Min. Negotiated Rate	$14,438.12
Max. Negotiated Rate	$25,176.23
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$21,343.23
Rate for Payer: Anthem Blue Cross of IN Traditional	$25,176.23
Rate for Payer: Plain Church Group Ministry All Commercial	$14,438.12
Rate for Payer: Three Rivers Preferred All Commercial	$18,857.16

INPATIENT MSDRG 256: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC

Facility IP

$16,016.78

Service Code	MS-DRG 256
Hospital Charge Code	MSDRG 256
Min. Negotiated Rate	$9,185.34
Max. Negotiated Rate	$16,016.78
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$13,578.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,016.78
Rate for Payer: Plain Church Group Ministry All Commercial	$9,185.34
Rate for Payer: Three Rivers Preferred All Commercial	$11,996.67

INPATIENT MSDRG 257: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC

Facility IP

$10,290.89

Service Code	MS-DRG 257
Hospital Charge Code	MSDRG 257
Min. Negotiated Rate	$5,901.64
Max. Negotiated Rate	$10,290.89
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$8,724.14
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,290.89
Rate for Payer: Plain Church Group Ministry All Commercial	$5,901.64
Rate for Payer: Three Rivers Preferred All Commercial	$7,707.95

INPATIENT MSDRG 258: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC

Facility IP

$27,979.81

Service Code	MS-DRG 258
Hospital Charge Code	MSDRG 258
Min. Negotiated Rate	$16,045.92
Max. Negotiated Rate	$27,979.81
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$23,719.96
Rate for Payer: Anthem Blue Cross of IN Traditional	$27,979.81
Rate for Payer: Plain Church Group Ministry All Commercial	$16,045.92
Rate for Payer: Three Rivers Preferred All Commercial	$20,957.06

INPATIENT MSDRG 259: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC

Facility IP

$19,568.10

Service Code	MS-DRG 259
Hospital Charge Code	MSDRG 259
Min. Negotiated Rate	$11,221.96
Max. Negotiated Rate	$19,568.10
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$16,588.92
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,568.10
Rate for Payer: Plain Church Group Ministry All Commercial	$11,221.96
Rate for Payer: Three Rivers Preferred All Commercial	$14,656.64

INPATIENT MSDRG 260: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC

Facility IP

$34,331.76

Service Code	MS-DRG 260
Hospital Charge Code	MSDRG 260
Min. Negotiated Rate	$19,688.65
Max. Negotiated Rate	$34,331.76
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$29,104.85
Rate for Payer: Anthem Blue Cross of IN Traditional	$34,331.76
Rate for Payer: Plain Church Group Ministry All Commercial	$19,688.65
Rate for Payer: Three Rivers Preferred All Commercial	$25,714.71

INPATIENT MSDRG 261: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC

Facility IP

$18,750.68

Service Code	MS-DRG 261
Hospital Charge Code	MSDRG 261
Min. Negotiated Rate	$10,753.18
Max. Negotiated Rate	$18,750.68
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,895.95
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,750.68
Rate for Payer: Plain Church Group Ministry All Commercial	$10,753.18
Rate for Payer: Three Rivers Preferred All Commercial	$14,044.38

INPATIENT MSDRG 262: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC

Facility IP

$16,454.44

Service Code	MS-DRG 262
Hospital Charge Code	MSDRG 262
Min. Negotiated Rate	$9,436.33
Max. Negotiated Rate	$16,454.44
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$13,949.30
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,454.44
Rate for Payer: Plain Church Group Ministry All Commercial	$9,436.33
Rate for Payer: Three Rivers Preferred All Commercial	$12,324.48

Price Transparency.

All Charges