Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$5,014.42

Service Code	APR-DRG 2331
Min. Negotiated Rate	$4,228.50
Max. Negotiated Rate	$5,014.42
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,228.50
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,228.50
Rate for Payer: Managed Health Services Medicaid	$4,228.50
Rate for Payer: MDWise Medicaid	$4,228.50

APR-DRG 36.00: APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$14,265.17

Service Code	APR-DRG 2334
Min. Negotiated Rate	$10,571.25
Max. Negotiated Rate	$14,265.17
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,571.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,571.25
Rate for Payer: Managed Health Services Medicaid	$10,571.25
Rate for Payer: MDWise Medicaid	$10,571.25

APR-DRG 36.00: APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$6,440.94

Service Code	APR-DRG 2332
Min. Negotiated Rate	$5,849.43
Max. Negotiated Rate	$6,440.94
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,849.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,849.43
Rate for Payer: Managed Health Services Medicaid	$5,849.43
Rate for Payer: MDWise Medicaid	$5,849.43

APR-DRG 36.00: APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$9,077.84

Service Code	APR-DRG 2333
Min. Negotiated Rate	$5,849.43
Max. Negotiated Rate	$9,077.84
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,849.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,849.43
Rate for Payer: Managed Health Services Medicaid	$5,849.43
Rate for Payer: MDWise Medicaid	$5,849.43

APR-DRG 36.00: APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$12,665.75

Service Code	APR-DRG 2344
Min. Negotiated Rate	$5,391.34
Max. Negotiated Rate	$12,665.75
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

$4,668.60

Service Code	APR-DRG 2341
Min. Negotiated Rate	$3,030.43
Max. Negotiated Rate	$4,668.60
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,030.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,030.43
Rate for Payer: Managed Health Services Medicaid	$3,030.43
Rate for Payer: MDWise Medicaid	$3,030.43

APR-DRG 36.00: APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$5,706.07

Service Code	APR-DRG 2342
Min. Negotiated Rate	$3,558.99
Max. Negotiated Rate	$5,706.07
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

$8,775.24

Service Code	APR-DRG 2343
Min. Negotiated Rate	$5,391.34
Max. Negotiated Rate	$8,775.24
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

$3,242.09

Service Code	APR-DRG 1412
Min. Negotiated Rate	$2,396.15
Max. Negotiated Rate	$3,242.09
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

$2,550.44

Service Code	APR-DRG 1411
Min. Negotiated Rate	$1,832.35
Max. Negotiated Rate	$2,550.44
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: ASTHMA

Facility

$4,063.41

Service Code	APR-DRG 1413
Min. Negotiated Rate	$3,136.14
Max. Negotiated Rate	$4,063.41
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

$7,521.64

Service Code	APR-DRG 1414
Min. Negotiated Rate	$5,038.96
Max. Negotiated Rate	$7,521.64
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: AUTOLOGOUS BONE MARROW TRANSPLANT

Facility

$29,308.45

Service Code	APR-DRG 0083
Min. Negotiated Rate	$19,627.29
Max. Negotiated Rate	$29,308.45
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

$41,628.37

Service Code	APR-DRG 0084
Min. Negotiated Rate	$29,423.31
Max. Negotiated Rate	$41,628.37
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

$19,627.29

Service Code	APR-DRG 0081
Min. Negotiated Rate	$15,907.83
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

$20,100.93

Service Code	APR-DRG 0082
Min. Negotiated Rate	$19,627.29
Max. Negotiated Rate	$20,100.93
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

$14,221.95

Service Code	APR-DRG 0494
Min. Negotiated Rate	$13,073.11
Max. Negotiated Rate	$14,221.95
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

$7,608.09

Service Code	APR-DRG 0492
Min. Negotiated Rate	$6,060.85
Max. Negotiated Rate	$7,608.09
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

$6,657.08

Service Code	APR-DRG 0491
Min. Negotiated Rate	$5,532.29
Max. Negotiated Rate	$6,657.08
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

$10,763.72

Service Code	APR-DRG 0493
Min. Negotiated Rate	$6,800.84
Max. Negotiated Rate	$10,763.72
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

$20,966.31

Service Code	APR-DRG 1324
Min. Negotiated Rate	$7,219.04
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

$2,463.98

Service Code	APR-DRG 1321
Min. Negotiated Rate	$2,431.39
Max. Negotiated Rate	$2,463.98
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: BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility

$3,847.27

Service Code	APR-DRG 1322
Min. Negotiated Rate	$3,664.70
Max. Negotiated Rate	$3,847.27
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

$6,397.71

Service Code	APR-DRG 1323
Min. Negotiated Rate	$3,664.70
Max. Negotiated Rate	$6,397.71
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: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility

$3,155.63

Service Code	APR-DRG 0561
Min. Negotiated Rate	$1,797.11
Max. Negotiated Rate	$3,155.63
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

Know your out-of-pocket cost for care.

All Charges