Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT MSDRG 904: SKIN GRAFTS FOR INJURIES WITH CC/MCC

Facility IP

$34,854.79

Service Code	MS-DRG 904
Hospital Charge Code	MSDRG 904
Min. Negotiated Rate	$19,988.60
Max. Negotiated Rate	$34,854.79
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$29,548.26
Rate for Payer: Anthem Blue Cross of IN Traditional	$34,854.79
Rate for Payer: Plain Church Group Ministry All Commercial	$19,988.60
Rate for Payer: Three Rivers Preferred All Commercial	$26,106.47

INPATIENT MSDRG 905: SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC

Facility IP

$15,307.30

Service Code	MS-DRG 905
Hospital Charge Code	MSDRG 905
Min. Negotiated Rate	$8,778.46
Max. Negotiated Rate	$15,307.30
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,976.81
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,307.30
Rate for Payer: Plain Church Group Ministry All Commercial	$8,778.46
Rate for Payer: Three Rivers Preferred All Commercial	$11,465.27

INPATIENT MSDRG 906: HAND PROCEDURES FOR INJURIES

Facility IP

$17,543.68

Service Code	MS-DRG 906
Hospital Charge Code	MSDRG 906
Min. Negotiated Rate	$10,060.99
Max. Negotiated Rate	$17,543.68
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,872.71
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,543.68
Rate for Payer: Plain Church Group Ministry All Commercial	$10,060.99
Rate for Payer: Three Rivers Preferred All Commercial	$13,140.33

INPATIENT MSDRG 907: OTHER O.R. PROCEDURES FOR INJURIES WITH MCC

Facility IP

$37,934.11

Service Code	MS-DRG 907
Hospital Charge Code	MSDRG 907
Min. Negotiated Rate	$21,754.54
Max. Negotiated Rate	$37,934.11
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$32,158.76
Rate for Payer: Anthem Blue Cross of IN Traditional	$37,934.11
Rate for Payer: Plain Church Group Ministry All Commercial	$21,754.54
Rate for Payer: Three Rivers Preferred All Commercial	$28,412.90

INPATIENT MSDRG 908: OTHER O.R. PROCEDURES FOR INJURIES WITH CC

Facility IP

$20,180.43

Service Code	MS-DRG 908
Hospital Charge Code	MSDRG 908
Min. Negotiated Rate	$11,573.12
Max. Negotiated Rate	$20,180.43
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$17,108.02
Rate for Payer: Anthem Blue Cross of IN Traditional	$20,180.43
Rate for Payer: Plain Church Group Ministry All Commercial	$11,573.12
Rate for Payer: Three Rivers Preferred All Commercial	$15,115.28

INPATIENT MSDRG 909: OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC

Facility IP

$13,391.80

Service Code	MS-DRG 909
Hospital Charge Code	MSDRG 909
Min. Negotiated Rate	$7,679.96
Max. Negotiated Rate	$13,391.80
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$11,352.94
Rate for Payer: Anthem Blue Cross of IN Traditional	$13,391.80
Rate for Payer: Plain Church Group Ministry All Commercial	$7,679.96
Rate for Payer: Three Rivers Preferred All Commercial	$10,030.55

INPATIENT MSDRG 913: TRAUMATIC INJURY WITH MCC

Facility IP

$14,857.86

Service Code	MS-DRG 913
Hospital Charge Code	MSDRG 913
Min. Negotiated Rate	$8,520.72
Max. Negotiated Rate	$14,857.86
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,595.80
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,857.86
Rate for Payer: Plain Church Group Ministry All Commercial	$8,520.72
Rate for Payer: Three Rivers Preferred All Commercial	$11,128.64

INPATIENT MSDRG 914: TRAUMATIC INJURY WITHOUT MCC

Facility IP

$8,724.74

Service Code	MS-DRG 914
Hospital Charge Code	MSDRG 914
Min. Negotiated Rate	$5,003.48
Max. Negotiated Rate	$8,724.74
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,396.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,724.74
Rate for Payer: Plain Church Group Ministry All Commercial	$5,003.48
Rate for Payer: Three Rivers Preferred All Commercial	$6,534.89

INPATIENT MSDRG 915: ALLERGIC REACTIONS WITH MCC

Facility IP

$17,860.64

Service Code	MS-DRG 915
Hospital Charge Code	MSDRG 915
Min. Negotiated Rate	$10,242.76
Max. Negotiated Rate	$17,860.64
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,141.41
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,860.64
Rate for Payer: Plain Church Group Ministry All Commercial	$10,242.76
Rate for Payer: Three Rivers Preferred All Commercial	$13,377.74

INPATIENT MSDRG 916: ALLERGIC REACTIONS WITHOUT MCC

Facility IP

$6,517.79

Service Code	MS-DRG 916
Hospital Charge Code	MSDRG 916
Min. Negotiated Rate	$3,737.84
Max. Negotiated Rate	$6,517.79
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$5,525.48
Rate for Payer: Anthem Blue Cross of IN Traditional	$6,517.79
Rate for Payer: Plain Church Group Ministry All Commercial	$3,737.84
Rate for Payer: Three Rivers Preferred All Commercial	$4,881.87

INPATIENT MSDRG 917: POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC

Facility IP

$14,940.29

Service Code	MS-DRG 917
Hospital Charge Code	MSDRG 917
Min. Negotiated Rate	$8,567.99
Max. Negotiated Rate	$14,940.29
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,665.68
Rate for Payer: Anthem Blue Cross of IN Traditional	$14,940.29
Rate for Payer: Plain Church Group Ministry All Commercial	$8,567.99
Rate for Payer: Three Rivers Preferred All Commercial	$11,190.38

INPATIENT MSDRG 918: POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC

Facility IP

$8,024.09

Service Code	MS-DRG 918
Hospital Charge Code	MSDRG 918
Min. Negotiated Rate	$4,601.67
Max. Negotiated Rate	$8,024.09
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,802.45
Rate for Payer: Anthem Blue Cross of IN Traditional	$8,024.09
Rate for Payer: Plain Church Group Ministry All Commercial	$4,601.67
Rate for Payer: Three Rivers Preferred All Commercial	$6,010.10

INPATIENT MSDRG 919: COMPLICATIONS OF TREATMENT WITH MCC

Facility IP

$17,600.60

Service Code	MS-DRG 919
Hospital Charge Code	MSDRG 919
Min. Negotiated Rate	$10,093.63
Max. Negotiated Rate	$17,600.60
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$14,920.96
Rate for Payer: Anthem Blue Cross of IN Traditional	$17,600.60
Rate for Payer: Plain Church Group Ministry All Commercial	$10,093.63
Rate for Payer: Three Rivers Preferred All Commercial	$13,182.96

INPATIENT MSDRG 920: COMPLICATIONS OF TREATMENT WITH CC

Facility IP

$10,026.92

Service Code	MS-DRG 920
Hospital Charge Code	MSDRG 920
Min. Negotiated Rate	$5,750.26
Max. Negotiated Rate	$10,026.92
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$8,500.35
Rate for Payer: Anthem Blue Cross of IN Traditional	$10,026.92
Rate for Payer: Plain Church Group Ministry All Commercial	$5,750.26
Rate for Payer: Three Rivers Preferred All Commercial	$7,510.23

INPATIENT MSDRG 921: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC

Facility IP

$7,142.88

Service Code	MS-DRG 921
Hospital Charge Code	MSDRG 921
Min. Negotiated Rate	$4,096.32
Max. Negotiated Rate	$7,142.88
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$6,055.40
Rate for Payer: Anthem Blue Cross of IN Traditional	$7,142.88
Rate for Payer: Plain Church Group Ministry All Commercial	$4,096.32
Rate for Payer: Three Rivers Preferred All Commercial	$5,350.07

INPATIENT MSDRG 922: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC

Facility IP

$15,267.07

Service Code	MS-DRG 922
Hospital Charge Code	MSDRG 922
Min. Negotiated Rate	$8,755.39
Max. Negotiated Rate	$15,267.07
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$12,942.70
Rate for Payer: Anthem Blue Cross of IN Traditional	$15,267.07
Rate for Payer: Plain Church Group Ministry All Commercial	$8,755.39
Rate for Payer: Three Rivers Preferred All Commercial	$11,435.13

INPATIENT MSDRG 923: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC

Facility IP

$9,255.62

Service Code	MS-DRG 923
Hospital Charge Code	MSDRG 923
Min. Negotiated Rate	$5,307.93
Max. Negotiated Rate	$9,255.62
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$7,846.48
Rate for Payer: Anthem Blue Cross of IN Traditional	$9,255.62
Rate for Payer: Plain Church Group Ministry All Commercial	$5,307.93
Rate for Payer: Three Rivers Preferred All Commercial	$6,932.52

INPATIENT MSDRG 927: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT

Facility IP

$186,272.33

Service Code	MS-DRG 927
Hospital Charge Code	MSDRG 927
Min. Negotiated Rate	$106,823.85
Max. Negotiated Rate	$186,272.33
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$157,912.92
Rate for Payer: Anthem Blue Cross of IN Traditional	$186,272.33
Rate for Payer: Plain Church Group Ministry All Commercial	$106,823.85
Rate for Payer: Three Rivers Preferred All Commercial	$139,519.17

INPATIENT MSDRG 928: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC

Facility IP

$60,755.23

Service Code	MS-DRG 928
Hospital Charge Code	MSDRG 928
Min. Negotiated Rate	$34,842.04
Max. Negotiated Rate	$60,755.23
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$51,505.42
Rate for Payer: Anthem Blue Cross of IN Traditional	$60,755.23
Rate for Payer: Plain Church Group Ministry All Commercial	$34,842.04
Rate for Payer: Three Rivers Preferred All Commercial	$45,506.06

INPATIENT MSDRG 929: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC

Facility IP

$28,838.44

Service Code	MS-DRG 929
Hospital Charge Code	MSDRG 929
Min. Negotiated Rate	$16,538.33
Max. Negotiated Rate	$28,838.44
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$24,447.88
Rate for Payer: Anthem Blue Cross of IN Traditional	$28,838.44
Rate for Payer: Plain Church Group Ministry All Commercial	$16,538.33
Rate for Payer: Three Rivers Preferred All Commercial	$21,600.18

INPATIENT MSDRG 933: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT

Facility IP

$29,762.83

Service Code	MS-DRG 933
Hospital Charge Code	MSDRG 933
Min. Negotiated Rate	$17,068.45
Max. Negotiated Rate	$29,762.83
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$25,231.53
Rate for Payer: Anthem Blue Cross of IN Traditional	$29,762.83
Rate for Payer: Plain Church Group Ministry All Commercial	$17,068.45
Rate for Payer: Three Rivers Preferred All Commercial	$22,292.55

INPATIENT MSDRG 934: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY

Facility IP

$18,409.19

Service Code	MS-DRG 934
Hospital Charge Code	MSDRG 934
Min. Negotiated Rate	$10,557.34
Max. Negotiated Rate	$18,409.19
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$15,606.44
Rate for Payer: Anthem Blue Cross of IN Traditional	$18,409.19
Rate for Payer: Plain Church Group Ministry All Commercial	$10,557.34
Rate for Payer: Three Rivers Preferred All Commercial	$13,788.60

INPATIENT MSDRG 935: NON-EXTENSIVE BURNS

Facility IP

$19,862.49

Service Code	MS-DRG 935
Hospital Charge Code	MSDRG 935
Min. Negotiated Rate	$11,390.78
Max. Negotiated Rate	$19,862.49
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$16,838.49
Rate for Payer: Anthem Blue Cross of IN Traditional	$19,862.49
Rate for Payer: Plain Church Group Ministry All Commercial	$11,390.78
Rate for Payer: Three Rivers Preferred All Commercial	$14,877.14

INPATIENT MSDRG 939: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC

Facility IP

$30,391.84

Service Code	MS-DRG 939
Hospital Charge Code	MSDRG 939
Min. Negotiated Rate	$17,429.18
Max. Negotiated Rate	$30,391.84
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$25,764.77
Rate for Payer: Anthem Blue Cross of IN Traditional	$30,391.84
Rate for Payer: Plain Church Group Ministry All Commercial	$17,429.18
Rate for Payer: Three Rivers Preferred All Commercial	$22,763.69

INPATIENT MSDRG 940: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC

Facility IP

$21,620.98

Service Code	MS-DRG 940
Hospital Charge Code	MSDRG 940
Min. Negotiated Rate	$12,399.25
Max. Negotiated Rate	$21,620.98
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$18,329.25
Rate for Payer: Anthem Blue Cross of IN Traditional	$21,620.98
Rate for Payer: Plain Church Group Ministry All Commercial	$12,399.25
Rate for Payer: Three Rivers Preferred All Commercial	$16,194.26

Price Transparency.

All Charges