Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$5,273.79

Service Code	APR-DRG 2342
Min. Negotiated Rate	$3,558.99
Max. Negotiated Rate	$5,273.79
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,558.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,558.99
Rate for Payer: Managed Health Services Medicaid	$3,558.99
Rate for Payer: MDWise Medicaid	$3,558.99

APR-DRG 36.00: APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$8,083.60

Service Code	APR-DRG 2343
Min. Negotiated Rate	$5,391.34
Max. Negotiated Rate	$8,083.60
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,391.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,391.34
Rate for Payer: Managed Health Services Medicaid	$5,391.34
Rate for Payer: MDWise Medicaid	$5,391.34

APR-DRG 36.00: APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$11,671.51

Service Code	APR-DRG 2344
Min. Negotiated Rate	$5,391.34
Max. Negotiated Rate	$11,671.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,391.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,391.34
Rate for Payer: Managed Health Services Medicaid	$5,391.34
Rate for Payer: MDWise Medicaid	$5,391.34

APR-DRG 36.00: ASTHMA

Facility

$6,484.17

Service Code	APR-DRG 1414
Min. Negotiated Rate	$5,038.96
Max. Negotiated Rate	$6,484.17
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,038.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,038.96
Rate for Payer: Managed Health Services Medicaid	$5,038.96
Rate for Payer: MDWise Medicaid	$5,038.96

APR-DRG 36.00: ASTHMA

Facility

$3,847.27

Service Code	APR-DRG 1413
Min. Negotiated Rate	$3,136.14
Max. Negotiated Rate	$3,847.27
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,136.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,136.14
Rate for Payer: Managed Health Services Medicaid	$3,136.14
Rate for Payer: MDWise Medicaid	$3,136.14

APR-DRG 36.00: ASTHMA

Facility

$2,809.81

Service Code	APR-DRG 1412
Min. Negotiated Rate	$2,396.15
Max. Negotiated Rate	$2,809.81
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: ASTHMA

Facility

$1,945.25

Service Code	APR-DRG 1411
Min. Negotiated Rate	$1,832.35
Max. Negotiated Rate	$1,945.25
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,832.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,832.35
Rate for Payer: Managed Health Services Medicaid	$1,832.35
Rate for Payer: MDWise Medicaid	$1,832.35

APR-DRG 36.00: AUTOLOGOUS BONE MARROW TRANSPLANT

Facility

$35,792.62

Service Code	APR-DRG 0084
Min. Negotiated Rate	$29,423.31
Max. Negotiated Rate	$35,792.62
Rate for Payer: Anthem Blue Cross of IN Medicaid	$29,423.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$29,423.31
Rate for Payer: Managed Health Services Medicaid	$29,423.31
Rate for Payer: MDWise Medicaid	$29,423.31

APR-DRG 36.00: AUTOLOGOUS BONE MARROW TRANSPLANT

Facility

$19,755.10

Service Code	APR-DRG 0082
Min. Negotiated Rate	$19,627.29
Max. Negotiated Rate	$19,755.10
Rate for Payer: Anthem Blue Cross of IN Medicaid	$19,627.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$19,627.29
Rate for Payer: Managed Health Services Medicaid	$19,627.29
Rate for Payer: MDWise Medicaid	$19,627.29

APR-DRG 36.00: AUTOLOGOUS BONE MARROW TRANSPLANT

Facility

$19,627.29

Service Code	APR-DRG 0081
Min. Negotiated Rate	$16,685.93
Max. Negotiated Rate	$19,627.29
Rate for Payer: Anthem Blue Cross of IN Medicaid	$19,627.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$19,627.29
Rate for Payer: Managed Health Services Medicaid	$19,627.29
Rate for Payer: MDWise Medicaid	$19,627.29

APR-DRG 36.00: AUTOLOGOUS BONE MARROW TRANSPLANT

Facility

$25,201.81

Service Code	APR-DRG 0083
Min. Negotiated Rate	$19,627.29
Max. Negotiated Rate	$25,201.81
Rate for Payer: Anthem Blue Cross of IN Medicaid	$19,627.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$19,627.29
Rate for Payer: Managed Health Services Medicaid	$19,627.29
Rate for Payer: MDWise Medicaid	$19,627.29

APR-DRG 36.00: BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM

Facility

$5,532.29

Service Code	APR-DRG 0491
Min. Negotiated Rate	$5,187.34
Max. Negotiated Rate	$5,532.29
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,532.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,532.29
Rate for Payer: Managed Health Services Medicaid	$5,532.29
Rate for Payer: MDWise Medicaid	$5,532.29

APR-DRG 36.00: BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM

Facility

$14,178.72

Service Code	APR-DRG 0494
Min. Negotiated Rate	$13,073.11
Max. Negotiated Rate	$14,178.72
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,073.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,073.11
Rate for Payer: Managed Health Services Medicaid	$13,073.11
Rate for Payer: MDWise Medicaid	$13,073.11

APR-DRG 36.00: BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM

Facility

$6,354.49

Service Code	APR-DRG 0492
Min. Negotiated Rate	$6,060.85
Max. Negotiated Rate	$6,354.49
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,060.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,060.85
Rate for Payer: Managed Health Services Medicaid	$6,060.85
Rate for Payer: MDWise Medicaid	$6,060.85

APR-DRG 36.00: BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM

Facility

$9,164.29

Service Code	APR-DRG 0493
Min. Negotiated Rate	$6,800.84
Max. Negotiated Rate	$9,164.29
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,800.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,800.84
Rate for Payer: Managed Health Services Medicaid	$6,800.84
Rate for Payer: MDWise Medicaid	$6,800.84

APR-DRG 36.00: BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$5,533.16

Service Code	APR-DRG 1323
Min. Negotiated Rate	$3,664.70
Max. Negotiated Rate	$5,533.16
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,664.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,664.70
Rate for Payer: Managed Health Services Medicaid	$3,664.70
Rate for Payer: MDWise Medicaid	$3,664.70

APR-DRG 36.00: BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$20,966.31

Service Code	APR-DRG 1324
Min. Negotiated Rate	$7,694.55
Max. Negotiated Rate	$20,966.31
Rate for Payer: Anthem Blue Cross of IN Medicaid	$20,966.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$20,966.31
Rate for Payer: Managed Health Services Medicaid	$20,966.31
Rate for Payer: MDWise Medicaid	$20,966.31

APR-DRG 36.00: BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$3,664.70

Service Code	APR-DRG 1322
Min. Negotiated Rate	$3,285.31
Max. Negotiated Rate	$3,664.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,664.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,664.70
Rate for Payer: Managed Health Services Medicaid	$3,664.70
Rate for Payer: MDWise Medicaid	$3,664.70

APR-DRG 36.00: BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$2,431.39

Service Code	APR-DRG 1321
Min. Negotiated Rate	$1,945.25
Max. Negotiated Rate	$2,431.39
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,431.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,431.39
Rate for Payer: Managed Health Services Medicaid	$2,431.39
Rate for Payer: MDWise Medicaid	$2,431.39

APR-DRG 36.00: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility

$6,527.40

Service Code	APR-DRG 0563
Min. Negotiated Rate	$2,713.29
Max. Negotiated Rate	$6,527.40
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,713.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,713.29
Rate for Payer: Managed Health Services Medicaid	$2,713.29
Rate for Payer: MDWise Medicaid	$2,713.29

APR-DRG 36.00: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility

$3,112.40

Service Code	APR-DRG 0561
Min. Negotiated Rate	$1,797.11
Max. Negotiated Rate	$3,112.40
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,797.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,797.11
Rate for Payer: Managed Health Services Medicaid	$1,797.11
Rate for Payer: MDWise Medicaid	$1,797.11

APR-DRG 36.00: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility

$4,279.55

Service Code	APR-DRG 0562
Min. Negotiated Rate	$2,713.29
Max. Negotiated Rate	$4,279.55
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,713.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,713.29
Rate for Payer: Managed Health Services Medicaid	$2,713.29
Rate for Payer: MDWise Medicaid	$2,713.29

APR-DRG 36.00: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility

$11,671.51

Service Code	APR-DRG 0564
Min. Negotiated Rate	$2,713.29
Max. Negotiated Rate	$11,671.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,713.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,713.29
Rate for Payer: Managed Health Services Medicaid	$2,713.29
Rate for Payer: MDWise Medicaid	$2,713.29

APR-DRG 36.00: BREAST PROCEDURES EXCEPT MASTECTOMY

Facility

$12,622.52

Service Code	APR-DRG 3633
Min. Negotiated Rate	$9,478.89
Max. Negotiated Rate	$12,622.52
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,478.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,478.89
Rate for Payer: Managed Health Services Medicaid	$9,478.89
Rate for Payer: MDWise Medicaid	$9,478.89

APR-DRG 36.00: BREAST PROCEDURES EXCEPT MASTECTOMY

Facility

$9,250.75

Service Code	APR-DRG 3632
Min. Negotiated Rate	$7,857.96
Max. Negotiated Rate	$9,250.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,857.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,857.96
Rate for Payer: Managed Health Services Medicaid	$7,857.96
Rate for Payer: MDWise Medicaid	$7,857.96

Know your out-of-pocket cost for care.

All Charges