,,Cannon Memorial Hospital ,,,,
,,                          DISCLAIMER: Diagnostic related Groups(DRG) are how Medicare and other insurance companies pay for an inpatient admission to the hospital. ,,,,
,,The charges below are average charges for each DRG listed; this should only be used as a guide.,,,,
,,"                                             The amounts shown below do not reflect what your insurance company will hold you responsible for, copay, deductible and/or coinsurance; this is an average estimate.",,,,
,,Please call (828)262-4111 to get the most accurate estimate of the patient's responsibility of the charges!,,,,
DRG, Description , Avg Charge , Self-Pay , Min Allowable , Average Allowable , Max Allowable 
56, 056 Degenerative nervous system di ," 32,649.00 "," 16,324.50 "," 18,936.42 "," 24,160.26 "," 29,384.10 "
57, 057 Degenerative nervous system di ," 28,199.47 "," 14,099.74 "," 16,355.69 "," 20,867.61 "," 25,379.52 "
65, 065 Intracranial hemorrhage or cer ," 15,197.36 "," 7,598.68 "," 8,814.47 "," 11,246.05 "," 13,677.62 "
70, 070 Nonspecific cerebrovascular di ," 18,562.93 "," 9,281.47 "," 10,766.50 "," 13,736.57 "," 16,706.64 "
71, 071 Nonspecific cerebrovascular di ," 24,206.61 "," 12,103.31 "," 14,039.83 "," 17,912.89 "," 21,785.95 "
101, 101 Seizures w/o MCC ," 11,901.18 "," 5,950.59 "," 6,902.68 "," 8,806.87 "," 10,711.06 "
176, 176 Pulmonary embolism w/o MCC ," 12,522.86 "," 6,261.43 "," 7,263.26 "," 9,266.91 "," 11,270.57 "
189, 189 Pulmonary edema & respiratory ," 22,553.42 "," 11,276.71 "," 13,080.98 "," 16,689.53 "," 20,298.08 "
190, 190 Chronic obstructive pulmonary ," 12,715.66 "," 6,357.83 "," 7,375.08 "," 9,409.59 "," 11,444.09 "
191, 191 Chronic obstructive pulmonary ," 15,723.57 "," 7,861.79 "," 9,119.67 "," 11,635.44 "," 14,151.21 "
192, 192 Chronic Obstructive Pulmonary ," 13,553.99 "," 6,776.99 "," 7,861.31 "," 10,029.95 "," 12,198.59 "
193, 193 Simple pneumonia & pleurisy w ," 35,070.00 "," 17,535.00 "," 20,340.60 "," 25,951.80 "," 31,563.00 "
194, 194 Simple pneumonia & pleurisy w ," 16,442.93 "," 8,221.47 "," 9,536.90 "," 12,167.77 "," 14,798.64 "
195, 195 Simple pneumonia & pleurisy w/ ," 25,765.90 "," 12,882.95 "," 14,944.22 "," 19,066.76 "," 23,189.31 "
200, 200 Pneumothorax w CC ," 18,157.09 "," 9,078.55 "," 10,531.11 "," 13,436.25 "," 16,341.38 "
280," 280 Acute myocardial infarction, d "," 8,947.31 "," 4,473.65 "," 5,189.44 "," 6,621.01 "," 8,052.57 "
291, 291 Heart failure & shock w MCC ," 22,806.01 "," 11,403.01 "," 13,227.49 "," 16,876.45 "," 20,525.41 "
292, 292 Heart failure & shock w CC ," 13,637.24 "," 6,818.62 "," 7,909.60 "," 10,091.56 "," 12,273.52 "
293, 293 Heart failure & shock w/o CC/M ," 8,000.29 "," 4,000.15 "," 4,640.17 "," 5,920.21 "," 7,200.26 "
300, 300 Peripheral vascular disorders ," 6,196.45 "," 3,098.23 "," 3,593.94 "," 4,585.37 "," 5,576.81 "
306, 306 Cardiac Congenital & Valvular ," 14,150.58 "," 7,075.29 "," 8,207.33 "," 10,471.43 "," 12,735.52 "
308, 308 Cardiac arrhythmia & conductio ," 18,690.41 "," 9,345.21 "," 10,840.44 "," 13,830.90 "," 16,821.37 "
309, 309 Cardiac arrhythmia & conductio ," 10,498.02 "," 5,249.01 "," 6,088.85 "," 7,768.53 "," 9,448.22 "
315, 315 Other circulatory system diagn ," 11,670.42 "," 5,835.21 "," 6,768.84 "," 8,636.11 "," 10,503.38 "
330, 330 Major small & large bowel proc ," 50,210.09 "," 25,105.05 "," 29,121.85 "," 37,155.47 "," 45,189.08 "
372, 372 Major gastrointestinal disorde ," 31,460.74 "," 15,730.37 "," 18,247.23 "," 23,280.95 "," 28,314.67 "
373, 373 Major Gastrointestinal Disorder ," 24,248.26 "," 12,124.13 "," 14,063.99 "," 17,943.71 "," 21,823.43 "
377, 377 G.I. hemorrhage w MCC ," 33,061.59 "," 16,530.80 "," 19,175.72 "," 24,465.58 "," 29,755.43 "
384, 384 Uncomplicated Peptic Ulcer w/o ," 16,513.93 "," 8,256.97 "," 9,578.08 "," 12,220.31 "," 14,862.54 "
392," 392 Esophagitis, gastroent & misc "," 14,541.40 "," 7,270.70 "," 8,434.01 "," 10,760.64 "," 13,087.26 "
418, 418 Laparoscopic cholecystectomy w ," 41,926.67 "," 20,963.34 "," 24,317.47 "," 31,025.74 "," 37,734.00 "
433, 433 Cirrhosis & alcoholic hepatiti ," 17,349.12 "," 8,674.56 "," 10,062.49 "," 12,838.35 "," 15,614.21 "
542, 542 Pathological fractures & muscu ," 17,953.60 "," 8,976.80 "," 10,413.09 "," 13,285.66 "," 16,158.24 "
552, 552 Medical back problems w/o MCC ," 14,795.86 "," 7,397.93 "," 8,581.60 "," 10,948.94 "," 13,316.27 "
556, 556 Signs & Symptoms of Musculoskeletal ," 11,465.66 "," 5,732.83 "," 6,650.08 "," 8,484.59 "," 10,319.09 "
593, 593 Skin Ulcers w CC ," 10,259.04 "," 5,129.52 "," 5,950.24 "," 7,591.69 "," 9,233.14 "
603, 603 Cellulitis w/o MCC ," 11,186.45 "," 5,593.22 "," 6,488.14 "," 8,277.97 "," 10,067.80 "
638, 638 Diabetes w CC ," 11,427.67 "," 5,713.83 "," 6,628.05 "," 8,456.47 "," 10,284.90 "
640, 640 Nutritional & misc metabolic d ," 20,180.66 "," 10,090.33 "," 11,704.78 "," 14,933.69 "," 18,162.59 "
641, 641 Nutritional & misc metabolic d ," 15,484.72 "," 7,742.36 "," 8,981.14 "," 11,458.69 "," 13,936.25 "
682, 682 Renal failure w MCC ," 18,573.04 "," 9,286.52 "," 10,772.36 "," 13,744.05 "," 16,715.73 "
683, 683 Renal failure w CC ," 10,071.39 "," 5,035.70 "," 5,841.41 "," 7,452.83 "," 9,064.25 "
689, 689 Kidney & urinary tract infecti ," 29,107.51 "," 14,553.75 "," 16,882.35 "," 21,539.55 "," 26,196.75 "
690, 690 Kidney & urinary tract infecti ," 11,241.82 "," 5,620.91 "," 6,520.25 "," 8,318.94 "," 10,117.64 "
809, 809 Major hematol/immun diag exc s ," 15,513.18 "," 7,756.59 "," 8,997.64 "," 11,479.75 "," 13,961.86 "
864, 864 Fever of unknown origin ," 11,273.07 "," 5,636.54 "," 6,538.38 "," 8,342.07 "," 10,145.76 "
871, 871 Septicemia w/o MV 96+ hours w ," 23,429.85 "," 11,714.93 "," 13,589.31 "," 17,338.09 "," 21,086.87 "
872, 872 Septicemia w/o MV 96+ hours w/ ," 15,268.93 "," 7,634.46 "," 8,855.98 "," 11,299.00 "," 13,742.03 "
884, 884 Organic disturbances & mental ," 5,028.14 "," 2,514.07 "," 2,916.32 "," 3,720.82 "," 4,525.32 "
917, 917 Poisoning & toxic effects of d ," 24,255.76 "," 12,127.88 "," 14,068.34 "," 17,949.26 "," 21,830.18 "
948, 948 Signs & symptoms w/o MCC ," 10,329.32 "," 5,164.66 "," 5,991.01 "," 7,643.70 "," 9,296.39 "
987, 987 Non-extensive O.R. proc unrela ," 19,296.25 "," 9,648.13 "," 11,191.83 "," 14,279.23 "," 17,366.63 "