Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT MSDRG 384: UNCOMPLICATED PEPTIC ULCER WITHOUT MCC

Facility IP

$8,847.40

Service Code	MS-DRG 384
Hospital Charge Code	MSDRG 384
Min. Negotiated Rate	$5,073.83
Max. Negotiated Rate	$8,847.40
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,500.41
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,847.40
Rate for Payer: Plain Church Group Ministry All Commercial	$5,073.83
Rate for Payer: Three Rivers Preferred All Commercial	$6,626.76

INPATIENT MSDRG 385: INFLAMMATORY BOWEL DISEASE WITH MCC

Facility IP

$15,982.43

Service Code	MS-DRG 385
Hospital Charge Code	MSDRG 385
Min. Negotiated Rate	$9,165.64
Max. Negotiated Rate	$15,982.43
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$13,549.16
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,982.43
Rate for Payer: Plain Church Group Ministry All Commercial	$9,165.64
Rate for Payer: Three Rivers Preferred All Commercial	$11,970.95

INPATIENT MSDRG 386: INFLAMMATORY BOWEL DISEASE WITH CC

Facility IP

$9,712.91

Service Code	MS-DRG 386
Hospital Charge Code	MSDRG 386
Min. Negotiated Rate	$5,570.18
Max. Negotiated Rate	$9,712.91
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$8,234.15
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,712.91
Rate for Payer: Plain Church Group Ministry All Commercial	$5,570.18
Rate for Payer: Three Rivers Preferred All Commercial	$7,275.03

INPATIENT MSDRG 387: INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC

Facility IP

$6,786.67

Service Code	MS-DRG 387
Hospital Charge Code	MSDRG 387
Min. Negotiated Rate	$3,892.03
Max. Negotiated Rate	$6,786.67
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$5,753.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,786.67
Rate for Payer: Plain Church Group Ministry All Commercial	$3,892.03
Rate for Payer: Three Rivers Preferred All Commercial	$5,083.26

INPATIENT MSDRG 388: GASTROINTESTINAL OBSTRUCTION WITH MCC

Facility IP

$14,399.60

Service Code	MS-DRG 388
Hospital Charge Code	MSDRG 388
Min. Negotiated Rate	$8,257.91
Max. Negotiated Rate	$14,399.60
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,207.30
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,399.60
Rate for Payer: Plain Church Group Ministry All Commercial	$8,257.91
Rate for Payer: Three Rivers Preferred All Commercial	$10,785.39

INPATIENT MSDRG 389: GASTROINTESTINAL OBSTRUCTION WITH CC

Facility IP

$7,920.07

Service Code	MS-DRG 389
Hospital Charge Code	MSDRG 389
Min. Negotiated Rate	$4,542.02
Max. Negotiated Rate	$7,920.07
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,714.26
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,920.07
Rate for Payer: Plain Church Group Ministry All Commercial	$4,542.02
Rate for Payer: Three Rivers Preferred All Commercial	$5,932.19

INPATIENT MSDRG 390: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC

Facility IP

$5,549.25

Service Code	MS-DRG 390
Hospital Charge Code	MSDRG 390
Min. Negotiated Rate	$3,182.40
Max. Negotiated Rate	$5,549.25
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$4,704.39
Rate for Payer: Anthem Blue Cross of IN Traditional	$5,549.25
Rate for Payer: Plain Church Group Ministry All Commercial	$3,182.40
Rate for Payer: Three Rivers Preferred All Commercial	$4,156.43

INPATIENT MSDRG 391: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC

Facility IP

$12,599.89

Service Code	MS-DRG 391
Hospital Charge Code	MSDRG 391
Min. Negotiated Rate	$7,225.81
Max. Negotiated Rate	$12,599.89
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$10,681.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$12,599.89
Rate for Payer: Plain Church Group Ministry All Commercial	$7,225.81
Rate for Payer: Three Rivers Preferred All Commercial	$9,437.40

INPATIENT MSDRG 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC

Facility IP

$7,728.72

Service Code	MS-DRG 392
Hospital Charge Code	MSDRG 392
Min. Negotiated Rate	$4,432.28
Max. Negotiated Rate	$7,728.72
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,552.04
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,728.72
Rate for Payer: Plain Church Group Ministry All Commercial	$4,432.28
Rate for Payer: Three Rivers Preferred All Commercial	$5,788.86

INPATIENT MSDRG 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC

Facility IP

$15,811.69

Service Code	MS-DRG 393
Hospital Charge Code	MSDRG 393
Min. Negotiated Rate	$9,067.72
Max. Negotiated Rate	$15,811.69
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$13,404.40
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,811.69
Rate for Payer: Plain Church Group Ministry All Commercial	$9,067.72
Rate for Payer: Three Rivers Preferred All Commercial	$11,843.06

INPATIENT MSDRG 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC

Facility IP

$9,253.66

Service Code	MS-DRG 394
Hospital Charge Code	MSDRG 394
Min. Negotiated Rate	$5,306.81
Max. Negotiated Rate	$9,253.66
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,844.82
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,253.66
Rate for Payer: Plain Church Group Ministry All Commercial	$5,306.81
Rate for Payer: Three Rivers Preferred All Commercial	$6,931.05

INPATIENT MSDRG 395: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC

Facility IP

$6,328.40

Service Code	MS-DRG 395
Hospital Charge Code	MSDRG 395
Min. Negotiated Rate	$3,629.23
Max. Negotiated Rate	$6,328.40
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$5,364.92
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,328.40
Rate for Payer: Plain Church Group Ministry All Commercial	$3,629.23
Rate for Payer: Three Rivers Preferred All Commercial	$4,740.02

INPATIENT MSDRG 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC

Facility IP

$54,382.66

Service Code	MS-DRG 405
Hospital Charge Code	MSDRG 405
Min. Negotiated Rate	$31,187.49
Max. Negotiated Rate	$54,382.66
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$46,103.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$54,382.66
Rate for Payer: Plain Church Group Ministry All Commercial	$31,187.49
Rate for Payer: Three Rivers Preferred All Commercial	$40,732.97

INPATIENT MSDRG 406: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC

Facility IP

$28,749.15

Service Code	MS-DRG 406
Hospital Charge Code	MSDRG 406
Min. Negotiated Rate	$16,487.12
Max. Negotiated Rate	$28,749.15
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$24,372.17
Rate for Payer: Anthem Blue Cross of IN Traditional	$28,749.15
Rate for Payer: Plain Church Group Ministry All Commercial	$16,487.12
Rate for Payer: Three Rivers Preferred All Commercial	$21,533.30

INPATIENT MSDRG 407: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC

Facility IP

$21,840.79

Service Code	MS-DRG 407
Hospital Charge Code	MSDRG 407
Min. Negotiated Rate	$12,525.30
Max. Negotiated Rate	$21,840.79
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$18,515.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,840.79
Rate for Payer: Plain Church Group Ministry All Commercial	$12,525.30
Rate for Payer: Three Rivers Preferred All Commercial	$16,358.90

INPATIENT MSDRG 408: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC

Facility IP

$36,008.80

Service Code	MS-DRG 408
Hospital Charge Code	MSDRG 408
Min. Negotiated Rate	$20,650.40
Max. Negotiated Rate	$36,008.80
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$30,526.57
Rate for Payer: Anthem Blue Cross of IN Traditional	$36,008.80
Rate for Payer: Plain Church Group Ministry All Commercial	$20,650.40
Rate for Payer: Three Rivers Preferred All Commercial	$26,970.83

INPATIENT MSDRG 409: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC

Facility IP

$20,915.43

Service Code	MS-DRG 409
Hospital Charge Code	MSDRG 409
Min. Negotiated Rate	$11,994.62
Max. Negotiated Rate	$20,915.43
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$17,731.12
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,915.43
Rate for Payer: Plain Church Group Ministry All Commercial	$11,994.62
Rate for Payer: Three Rivers Preferred All Commercial	$15,665.79

INPATIENT MSDRG 410: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC

Facility IP

$16,659.53

Service Code	MS-DRG 410
Hospital Charge Code	MSDRG 410
Min. Negotiated Rate	$9,553.94
Max. Negotiated Rate	$16,659.53
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,123.17
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,659.53
Rate for Payer: Plain Church Group Ministry All Commercial	$9,553.94
Rate for Payer: Three Rivers Preferred All Commercial	$12,478.10

INPATIENT MSDRG 411: CHOLECYSTECTOMY WITH C.D.E. WITH MCC

Facility IP

$33,150.28

Service Code	MS-DRG 411
Hospital Charge Code	MSDRG 411
Min. Negotiated Rate	$19,011.09
Max. Negotiated Rate	$33,150.28
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$28,103.25
Rate for Payer: Anthem Blue Cross of IN Traditional	$33,150.28
Rate for Payer: Plain Church Group Ministry All Commercial	$19,011.09
Rate for Payer: Three Rivers Preferred All Commercial	$24,829.77

INPATIENT MSDRG 412: CHOLECYSTECTOMY WITH C.D.E. WITH CC

Facility IP

$22,527.70

Service Code	MS-DRG 412
Hospital Charge Code	MSDRG 412
Min. Negotiated Rate	$12,919.24
Max. Negotiated Rate	$22,527.70
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$19,097.93
Rate for Payer: Anthem Blue Cross of IN Traditional	$22,527.70
Rate for Payer: Plain Church Group Ministry All Commercial	$12,919.24
Rate for Payer: Three Rivers Preferred All Commercial	$16,873.40

INPATIENT MSDRG 413: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC

Facility IP

$15,900.99

Service Code	MS-DRG 413
Hospital Charge Code	MSDRG 413
Min. Negotiated Rate	$9,118.93
Max. Negotiated Rate	$15,900.99
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$13,480.11
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,900.99
Rate for Payer: Plain Church Group Ministry All Commercial	$9,118.93
Rate for Payer: Three Rivers Preferred All Commercial	$11,909.94

INPATIENT MSDRG 414: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC

Facility IP

$34,686.01

Service Code	MS-DRG 414
Hospital Charge Code	MSDRG 414
Min. Negotiated Rate	$19,891.81
Max. Negotiated Rate	$34,686.01
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$29,405.17
Rate for Payer: Anthem Blue Cross of IN Traditional	$34,686.01
Rate for Payer: Plain Church Group Ministry All Commercial	$19,891.81
Rate for Payer: Three Rivers Preferred All Commercial	$25,980.05

INPATIENT MSDRG 415: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC

Facility IP

$19,626.00

Service Code	MS-DRG 415
Hospital Charge Code	MSDRG 415
Min. Negotiated Rate	$11,255.16
Max. Negotiated Rate	$19,626.00
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$16,638.00
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,626.00
Rate for Payer: Plain Church Group Ministry All Commercial	$11,255.16
Rate for Payer: Three Rivers Preferred All Commercial	$14,700.00

INPATIENT MSDRG 416: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC

Facility IP

$13,506.61

Service Code	MS-DRG 416
Hospital Charge Code	MSDRG 416
Min. Negotiated Rate	$7,745.80
Max. Negotiated Rate	$13,506.61
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$11,450.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,506.61
Rate for Payer: Plain Church Group Ministry All Commercial	$7,745.80
Rate for Payer: Three Rivers Preferred All Commercial	$10,116.54

INPATIENT MSDRG 417: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC

Facility IP

$23,332.37

Service Code	MS-DRG 417
Hospital Charge Code	MSDRG 417
Min. Negotiated Rate	$13,380.70
Max. Negotiated Rate	$23,332.37
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$19,780.09
Rate for Payer: Anthem Blue Cross of IN Traditional	$23,332.37
Rate for Payer: Plain Church Group Ministry All Commercial	$13,380.70
Rate for Payer: Three Rivers Preferred All Commercial	$17,476.10

Price Transparency.

All Charges