Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: ALLERGIC REACTIONS

Facility

$2,396.15

Service Code	APR-DRG 8112
Min. Negotiated Rate	$1,815.57
Max. Negotiated Rate	$2,396.15
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,396.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,396.15
Rate for Payer: Managed Health Services Medicaid	$2,396.15
Rate for Payer: MDWise Medicaid	$2,396.15

APR-DRG 36.00: ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$48,588.05

Service Code	APR-DRG 0073
Min. Negotiated Rate	$40,241.22
Max. Negotiated Rate	$48,588.05
Rate for Payer: Anthem Blue Cross of IN Medicaid	$40,241.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$40,241.22
Rate for Payer: Managed Health Services Medicaid	$40,241.22
Rate for Payer: MDWise Medicaid	$40,241.22

APR-DRG 36.00: ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$91,383.57

Service Code	APR-DRG 0074
Min. Negotiated Rate	$66,634.11
Max. Negotiated Rate	$91,383.57
Rate for Payer: Anthem Blue Cross of IN Medicaid	$66,634.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$66,634.11
Rate for Payer: Managed Health Services Medicaid	$66,634.11
Rate for Payer: MDWise Medicaid	$66,634.11

APR-DRG 36.00: ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$48,069.31

Service Code	APR-DRG 0072
Min. Negotiated Rate	$40,241.22
Max. Negotiated Rate	$48,069.31
Rate for Payer: Anthem Blue Cross of IN Medicaid	$40,241.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$40,241.22
Rate for Payer: Managed Health Services Medicaid	$40,241.22
Rate for Payer: MDWise Medicaid	$40,241.22

APR-DRG 36.00: ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$43,184.57

Service Code	APR-DRG 0071
Min. Negotiated Rate	$40,241.22
Max. Negotiated Rate	$43,184.57
Rate for Payer: Anthem Blue Cross of IN Medicaid	$40,241.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$40,241.22
Rate for Payer: Managed Health Services Medicaid	$40,241.22
Rate for Payer: MDWise Medicaid	$40,241.22

APR-DRG 36.00: ALTERATION IN CONSCIOUSNESS

Facility

$9,077.84

Service Code	APR-DRG 0524
Min. Negotiated Rate	$8,175.10
Max. Negotiated Rate	$9,077.84
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,175.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,175.10
Rate for Payer: Managed Health Services Medicaid	$8,175.10
Rate for Payer: MDWise Medicaid	$8,175.10

APR-DRG 36.00: ALTERATION IN CONSCIOUSNESS

Facility

$4,020.19

Service Code	APR-DRG 0522
Min. Negotiated Rate	$3,065.66
Max. Negotiated Rate	$4,020.19
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,065.66
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,065.66
Rate for Payer: Managed Health Services Medicaid	$3,065.66
Rate for Payer: MDWise Medicaid	$3,065.66

APR-DRG 36.00: ALTERATION IN CONSCIOUSNESS

Facility

$2,982.72

Service Code	APR-DRG 0521
Min. Negotiated Rate	$1,761.88
Max. Negotiated Rate	$2,982.72
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,761.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,761.88
Rate for Payer: Managed Health Services Medicaid	$1,761.88
Rate for Payer: MDWise Medicaid	$1,761.88

APR-DRG 36.00: ALTERATION IN CONSCIOUSNESS

Facility

$5,489.93

Service Code	APR-DRG 0523
Min. Negotiated Rate	$3,911.36
Max. Negotiated Rate	$5,489.93
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,911.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,911.36
Rate for Payer: Managed Health Services Medicaid	$3,911.36
Rate for Payer: MDWise Medicaid	$3,911.36

APR-DRG 36.00: AMPUTATION OF LOWER LIMB EXCEPT TOES

Facility

$7,737.78

Service Code	APR-DRG 3052
Min. Negotiated Rate	$5,708.48
Max. Negotiated Rate	$7,737.78
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,708.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,708.48
Rate for Payer: Managed Health Services Medicaid	$5,708.48
Rate for Payer: MDWise Medicaid	$5,708.48

APR-DRG 36.00: AMPUTATION OF LOWER LIMB EXCEPT TOES

Facility

$6,959.68

Service Code	APR-DRG 3051
Min. Negotiated Rate	$4,580.88
Max. Negotiated Rate	$6,959.68
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,580.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,580.88
Rate for Payer: Managed Health Services Medicaid	$4,580.88
Rate for Payer: MDWise Medicaid	$4,580.88

APR-DRG 36.00: AMPUTATION OF LOWER LIMB EXCEPT TOES

Facility

$11,412.14

Service Code	APR-DRG 3053
Min. Negotiated Rate	$9,020.80
Max. Negotiated Rate	$11,412.14
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,020.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,020.80
Rate for Payer: Managed Health Services Medicaid	$9,020.80
Rate for Payer: MDWise Medicaid	$9,020.80

APR-DRG 36.00: AMPUTATION OF LOWER LIMB EXCEPT TOES

Facility

$15,000.05

Service Code	APR-DRG 3054
Min. Negotiated Rate	$11,416.95
Max. Negotiated Rate	$15,000.05
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,416.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,416.95
Rate for Payer: Managed Health Services Medicaid	$11,416.95
Rate for Payer: MDWise Medicaid	$11,416.95

APR-DRG 36.00: ANAL PROCEDURES

Facility

$9,423.66

Service Code	APR-DRG 2263
Min. Negotiated Rate	$4,404.69
Max. Negotiated Rate	$9,423.66
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,404.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,404.69
Rate for Payer: Managed Health Services Medicaid	$4,404.69
Rate for Payer: MDWise Medicaid	$4,404.69

APR-DRG 36.00: ANAL PROCEDURES

Facility

$4,452.46

Service Code	APR-DRG 2261
Min. Negotiated Rate	$3,981.84
Max. Negotiated Rate	$4,452.46
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,981.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,981.84
Rate for Payer: Managed Health Services Medicaid	$3,981.84
Rate for Payer: MDWise Medicaid	$3,981.84

APR-DRG 36.00: ANAL PROCEDURES

Facility

$14,092.26

Service Code	APR-DRG 2264
Min. Negotiated Rate	$5,320.86
Max. Negotiated Rate	$14,092.26
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,320.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,320.86
Rate for Payer: Managed Health Services Medicaid	$5,320.86
Rate for Payer: MDWise Medicaid	$5,320.86

APR-DRG 36.00: ANAL PROCEDURES

Facility

$5,014.42

Service Code	APR-DRG 2262
Min. Negotiated Rate	$3,981.84
Max. Negotiated Rate	$5,014.42
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,981.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,981.84
Rate for Payer: Managed Health Services Medicaid	$3,981.84
Rate for Payer: MDWise Medicaid	$3,981.84

APR-DRG 36.00: ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS

Facility

$2,204.62

Service Code	APR-DRG 1981
Min. Negotiated Rate	$1,550.45
Max. Negotiated Rate	$2,204.62
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,550.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,550.45
Rate for Payer: Managed Health Services Medicaid	$1,550.45
Rate for Payer: MDWise Medicaid	$1,550.45

APR-DRG 36.00: ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS

Facility

$3,458.22

Service Code	APR-DRG 1983
Min. Negotiated Rate	$2,572.34
Max. Negotiated Rate	$3,458.22
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,572.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,572.34
Rate for Payer: Managed Health Services Medicaid	$2,572.34
Rate for Payer: MDWise Medicaid	$2,572.34

APR-DRG 36.00: ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS

Facility

$6,397.71

Service Code	APR-DRG 1984
Min. Negotiated Rate	$4,298.98
Max. Negotiated Rate	$6,397.71
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,298.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,298.98
Rate for Payer: Managed Health Services Medicaid	$4,298.98
Rate for Payer: MDWise Medicaid	$4,298.98

APR-DRG 36.00: ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS

Facility

$2,636.90

Service Code	APR-DRG 1982
Min. Negotiated Rate	$2,572.34
Max. Negotiated Rate	$2,636.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,572.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,572.34
Rate for Payer: Managed Health Services Medicaid	$2,572.34
Rate for Payer: MDWise Medicaid	$2,572.34

APR-DRG 36.00: ANOXIC & OTHER SEVERE BRAIN DAMAGE

Facility

$4,263.74

Service Code	APR-DRG 0591
Min. Negotiated Rate	$3,371.77
Max. Negotiated Rate	$4,263.74
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,263.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,263.74
Rate for Payer: Managed Health Services Medicaid	$4,263.74
Rate for Payer: MDWise Medicaid	$4,263.74

APR-DRG 36.00: ANOXIC & OTHER SEVERE BRAIN DAMAGE

Facility

$5,446.70

Service Code	APR-DRG 0592
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$5,446.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,263.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,263.74
Rate for Payer: Managed Health Services Medicaid	$4,263.74
Rate for Payer: MDWise Medicaid	$4,263.74

APR-DRG 36.00: ANOXIC & OTHER SEVERE BRAIN DAMAGE

Facility

$11,109.54

Service Code	APR-DRG 0594
Min. Negotiated Rate	$6,201.80
Max. Negotiated Rate	$11,109.54
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,201.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,201.80
Rate for Payer: Managed Health Services Medicaid	$6,201.80
Rate for Payer: MDWise Medicaid	$6,201.80

APR-DRG 36.00: ANOXIC & OTHER SEVERE BRAIN DAMAGE

Facility

$7,521.64

Service Code	APR-DRG 0593
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$7,521.64
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,263.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,263.74
Rate for Payer: Managed Health Services Medicaid	$4,263.74
Rate for Payer: MDWise Medicaid	$4,263.74

Know your out-of-pocket cost for care.

All Charges