Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT MSDRG 571: SKIN DEBRIDEMENT WITH CC

Facility IP

$16,177.71

Service Code	MS-DRG 571
Hospital Charge Code	MSDRG 571
Min. Negotiated Rate	$9,277.63
Max. Negotiated Rate	$16,177.71
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$13,714.70
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,177.71
Rate for Payer: Plain Church Group Ministry All Commercial	$9,277.63
Rate for Payer: Three Rivers Preferred All Commercial	$12,117.21

INPATIENT MSDRG 572: SKIN DEBRIDEMENT WITHOUT CC/MCC

Facility IP

$11,810.93

Service Code	MS-DRG 572
Hospital Charge Code	MSDRG 572
Min. Negotiated Rate	$6,773.36
Max. Negotiated Rate	$11,810.93
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$10,012.75
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,810.93
Rate for Payer: Plain Church Group Ministry All Commercial	$6,773.36
Rate for Payer: Three Rivers Preferred All Commercial	$8,846.46

INPATIENT MSDRG 573: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC

Facility IP

$57,607.22

Service Code	MS-DRG 573
Hospital Charge Code	MSDRG 573
Min. Negotiated Rate	$33,036.71
Max. Negotiated Rate	$57,607.22
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$48,836.69
Rate for Payer: Anthem Blue Cross of IN Traditional	$57,607.22
Rate for Payer: Plain Church Group Ministry All Commercial	$33,036.71
Rate for Payer: Three Rivers Preferred All Commercial	$43,148.18

INPATIENT MSDRG 574: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC

Facility IP

$35,371.94

Service Code	MS-DRG 574
Hospital Charge Code	MSDRG 574
Min. Negotiated Rate	$20,285.17
Max. Negotiated Rate	$35,371.94
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$29,986.67
Rate for Payer: Anthem Blue Cross of IN Traditional	$35,371.94
Rate for Payer: Plain Church Group Ministry All Commercial	$20,285.17
Rate for Payer: Three Rivers Preferred All Commercial	$26,493.81

INPATIENT MSDRG 575: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility IP

$20,112.72

Service Code	MS-DRG 575
Hospital Charge Code	MSDRG 575
Min. Negotiated Rate	$11,534.29
Max. Negotiated Rate	$20,112.72
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$17,050.62
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,112.72
Rate for Payer: Plain Church Group Ministry All Commercial	$11,534.29
Rate for Payer: Three Rivers Preferred All Commercial	$15,064.56

INPATIENT MSDRG 576: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC

Facility IP

$55,433.64

Service Code	MS-DRG 576
Hospital Charge Code	MSDRG 576
Min. Negotiated Rate	$31,790.20
Max. Negotiated Rate	$55,433.64
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$46,994.03
Rate for Payer: Anthem Blue Cross of IN Traditional	$55,433.64
Rate for Payer: Plain Church Group Ministry All Commercial	$31,790.20
Rate for Payer: Three Rivers Preferred All Commercial	$41,520.15

INPATIENT MSDRG 577: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC

Facility IP

$25,697.30

Service Code	MS-DRG 577
Hospital Charge Code	MSDRG 577
Min. Negotiated Rate	$14,736.94
Max. Negotiated Rate	$25,697.30
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$21,784.97
Rate for Payer: Anthem Blue Cross of IN Traditional	$25,697.30
Rate for Payer: Plain Church Group Ministry All Commercial	$14,736.94
Rate for Payer: Three Rivers Preferred All Commercial	$19,247.45

INPATIENT MSDRG 578: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility IP

$16,804.76

Service Code	MS-DRG 578
Hospital Charge Code	MSDRG 578
Min. Negotiated Rate	$9,637.23
Max. Negotiated Rate	$16,804.76
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,246.29
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,804.76
Rate for Payer: Plain Church Group Ministry All Commercial	$9,637.23
Rate for Payer: Three Rivers Preferred All Commercial	$12,586.88

INPATIENT MSDRG 579: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC

Facility IP

$30,927.63

Service Code	MS-DRG 579
Hospital Charge Code	MSDRG 579
Min. Negotiated Rate	$17,736.44
Max. Negotiated Rate	$30,927.63
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$26,218.99
Rate for Payer: Anthem Blue Cross of IN Traditional	$30,927.63
Rate for Payer: Plain Church Group Ministry All Commercial	$17,736.44
Rate for Payer: Three Rivers Preferred All Commercial	$23,165.00

INPATIENT MSDRG 580: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC

Facility IP

$17,037.33

Service Code	MS-DRG 580
Hospital Charge Code	MSDRG 580
Min. Negotiated Rate	$9,770.60
Max. Negotiated Rate	$17,037.33
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,443.45
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,037.33
Rate for Payer: Plain Church Group Ministry All Commercial	$9,770.60
Rate for Payer: Three Rivers Preferred All Commercial	$12,761.07

INPATIENT MSDRG 581: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC

Facility IP

$13,851.05

Service Code	MS-DRG 581
Hospital Charge Code	MSDRG 581
Min. Negotiated Rate	$7,943.33
Max. Negotiated Rate	$13,851.05
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$11,742.27
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,851.05
Rate for Payer: Plain Church Group Ministry All Commercial	$7,943.33
Rate for Payer: Three Rivers Preferred All Commercial	$10,374.53

INPATIENT MSDRG 582: MASTECTOMY FOR MALIGNANCY WITH CC/MCC

Facility IP

$18,986.19

Service Code	MS-DRG 582
Hospital Charge Code	MSDRG 582
Min. Negotiated Rate	$10,888.24
Max. Negotiated Rate	$18,986.19
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$16,095.60
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,986.19
Rate for Payer: Plain Church Group Ministry All Commercial	$10,888.24
Rate for Payer: Three Rivers Preferred All Commercial	$14,220.78

INPATIENT MSDRG 583: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC

Facility IP

$14,825.48

Service Code	MS-DRG 583
Hospital Charge Code	MSDRG 583
Min. Negotiated Rate	$8,502.15
Max. Negotiated Rate	$14,825.48
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,568.35
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,825.48
Rate for Payer: Plain Church Group Ministry All Commercial	$8,502.15
Rate for Payer: Three Rivers Preferred All Commercial	$11,104.38

INPATIENT MSDRG 584: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC

Facility IP

$20,958.61

Service Code	MS-DRG 584
Hospital Charge Code	MSDRG 584
Min. Negotiated Rate	$12,019.39
Max. Negotiated Rate	$20,958.61
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$17,767.72
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,958.61
Rate for Payer: Plain Church Group Ministry All Commercial	$12,019.39
Rate for Payer: Three Rivers Preferred All Commercial	$15,698.13

INPATIENT MSDRG 585: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC

Facility IP

$18,066.71

Service Code	MS-DRG 585
Hospital Charge Code	MSDRG 585
Min. Negotiated Rate	$10,360.94
Max. Negotiated Rate	$18,066.71
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,316.11
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,066.71
Rate for Payer: Plain Church Group Ministry All Commercial	$10,360.94
Rate for Payer: Three Rivers Preferred All Commercial	$13,532.09

INPATIENT MSDRG 592: SKIN ULCERS WITH MCC

Facility IP

$17,506.39

Service Code	MS-DRG 592
Hospital Charge Code	MSDRG 592
Min. Negotiated Rate	$10,039.60
Max. Negotiated Rate	$17,506.39
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,841.10
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,506.39
Rate for Payer: Plain Church Group Ministry All Commercial	$10,039.60
Rate for Payer: Three Rivers Preferred All Commercial	$13,112.40

INPATIENT MSDRG 593: SKIN ULCERS WITH CC

Facility IP

$11,303.59

Service Code	MS-DRG 593
Hospital Charge Code	MSDRG 593
Min. Negotiated Rate	$6,482.41
Max. Negotiated Rate	$11,303.59
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$9,582.66
Rate for Payer: Anthem Blue Cross of IN Traditional	$11,303.59
Rate for Payer: Plain Church Group Ministry All Commercial	$6,482.41
Rate for Payer: Three Rivers Preferred All Commercial	$8,466.47

INPATIENT MSDRG 594: SKIN ULCERS WITHOUT CC/MCC

Facility IP

$7,594.28

Service Code	MS-DRG 594
Hospital Charge Code	MSDRG 594
Min. Negotiated Rate	$4,355.18
Max. Negotiated Rate	$7,594.28
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,438.07
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,594.28
Rate for Payer: Plain Church Group Ministry All Commercial	$4,355.18
Rate for Payer: Three Rivers Preferred All Commercial	$5,688.17

INPATIENT MSDRG 595: MAJOR SKIN DISORDERS WITH MCC

Facility IP

$21,013.56

Service Code	MS-DRG 595
Hospital Charge Code	MSDRG 595
Min. Negotiated Rate	$12,050.90
Max. Negotiated Rate	$21,013.56
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$17,814.31
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,013.56
Rate for Payer: Plain Church Group Ministry All Commercial	$12,050.90
Rate for Payer: Three Rivers Preferred All Commercial	$15,739.29

INPATIENT MSDRG 596: MAJOR SKIN DISORDERS WITHOUT MCC

Facility IP

$10,713.83

Service Code	MS-DRG 596
Hospital Charge Code	MSDRG 596
Min. Negotiated Rate	$6,144.19
Max. Negotiated Rate	$10,713.83
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$9,082.68
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,713.83
Rate for Payer: Plain Church Group Ministry All Commercial	$6,144.19
Rate for Payer: Three Rivers Preferred All Commercial	$8,024.73

INPATIENT MSDRG 597: MALIGNANT BREAST DISORDERS WITH MCC

Facility IP

$16,525.09

Service Code	MS-DRG 597
Hospital Charge Code	MSDRG 597
Min. Negotiated Rate	$9,476.84
Max. Negotiated Rate	$16,525.09
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,009.20
Rate for Payer: Anthem Blue Cross of IN Traditional	$16,525.09
Rate for Payer: Plain Church Group Ministry All Commercial	$9,476.84
Rate for Payer: Three Rivers Preferred All Commercial	$12,377.40

INPATIENT MSDRG 598: MALIGNANT BREAST DISORDERS WITH CC

Facility IP

$10,481.27

Service Code	MS-DRG 598
Hospital Charge Code	MSDRG 598
Min. Negotiated Rate	$6,010.82
Max. Negotiated Rate	$10,481.27
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$8,885.52
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,481.27
Rate for Payer: Plain Church Group Ministry All Commercial	$6,010.82
Rate for Payer: Three Rivers Preferred All Commercial	$7,850.54

INPATIENT MSDRG 599: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility IP

$7,336.20

Service Code	MS-DRG 599
Hospital Charge Code	MSDRG 599
Min. Negotiated Rate	$4,207.18
Max. Negotiated Rate	$7,336.20
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,219.28
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,336.20
Rate for Payer: Plain Church Group Ministry All Commercial	$4,207.18
Rate for Payer: Three Rivers Preferred All Commercial	$5,494.86

INPATIENT MSDRG 600: NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

Facility IP

$10,216.31

Service Code	MS-DRG 600
Hospital Charge Code	MSDRG 600
Min. Negotiated Rate	$5,858.87
Max. Negotiated Rate	$10,216.31
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$8,660.91
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,216.31
Rate for Payer: Plain Church Group Ministry All Commercial	$5,858.87
Rate for Payer: Three Rivers Preferred All Commercial	$7,652.09

INPATIENT MSDRG 601: NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility IP

$6,907.37

Service Code	MS-DRG 601
Hospital Charge Code	MSDRG 601
Min. Negotiated Rate	$3,961.25
Max. Negotiated Rate	$6,907.37
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$5,855.74
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,907.37
Rate for Payer: Plain Church Group Ministry All Commercial	$3,961.25
Rate for Payer: Three Rivers Preferred All Commercial	$5,173.67

Price Transparency.

All Charges