Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: BREAST PROCEDURES EXCEPT MASTECTOMY

Facility

$5,792.53

Service Code	APR-DRG 3631
Min. Negotiated Rate	$4,334.21
Max. Negotiated Rate	$5,792.53
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,334.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,334.21
Rate for Payer: Managed Health Services Medicaid	$4,334.21
Rate for Payer: MDWise Medicaid	$4,334.21

APR-DRG 36.00: BREAST PROCEDURES EXCEPT MASTECTOMY

Facility

$13,703.21

Service Code	APR-DRG 3634
Min. Negotiated Rate	$10,853.15
Max. Negotiated Rate	$13,703.21
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,853.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,853.15
Rate for Payer: Managed Health Services Medicaid	$10,853.15
Rate for Payer: MDWise Medicaid	$10,853.15

APR-DRG 36.00: BRONCHIOLITIS & RSV PNEUMONIA

Facility

$1,726.64

Service Code	APR-DRG 1381
Min. Negotiated Rate	$1,469.75
Max. Negotiated Rate	$1,726.64
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,726.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,726.64
Rate for Payer: Managed Health Services Medicaid	$1,726.64
Rate for Payer: MDWise Medicaid	$1,726.64

APR-DRG 36.00: BRONCHIOLITIS & RSV PNEUMONIA

Facility

$2,396.15

Service Code	APR-DRG 1382
Min. Negotiated Rate	$2,377.53
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: BRONCHIOLITIS & RSV PNEUMONIA

Facility

$8,126.83

Service Code	APR-DRG 1384
Min. Negotiated Rate	$6,730.36
Max. Negotiated Rate	$8,126.83
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,730.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,730.36
Rate for Payer: Managed Health Services Medicaid	$6,730.36
Rate for Payer: MDWise Medicaid	$6,730.36

APR-DRG 36.00: BRONCHIOLITIS & RSV PNEUMONIA

Facility

$4,149.87

Service Code	APR-DRG 1383
Min. Negotiated Rate	$3,347.56
Max. Negotiated Rate	$4,149.87
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,347.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,347.56
Rate for Payer: Managed Health Services Medicaid	$3,347.56
Rate for Payer: MDWise Medicaid	$3,347.56

APR-DRG 36.00: CARDIAC ARREST & SHOCK

Facility

$2,550.44

Service Code	APR-DRG 1962
Min. Negotiated Rate	$1,867.59
Max. Negotiated Rate	$2,550.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,867.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,867.59
Rate for Payer: Managed Health Services Medicaid	$1,867.59
Rate for Payer: MDWise Medicaid	$1,867.59

APR-DRG 36.00: CARDIAC ARREST & SHOCK

Facility

$4,279.55

Service Code	APR-DRG 1963
Min. Negotiated Rate	$2,995.19
Max. Negotiated Rate	$4,279.55
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,995.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,995.19
Rate for Payer: Managed Health Services Medicaid	$2,995.19
Rate for Payer: MDWise Medicaid	$2,995.19

APR-DRG 36.00: CARDIAC ARREST & SHOCK

Facility

$8,515.88

Service Code	APR-DRG 1964
Min. Negotiated Rate	$7,646.54
Max. Negotiated Rate	$8,515.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,646.54
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,646.54
Rate for Payer: Managed Health Services Medicaid	$7,646.54
Rate for Payer: MDWise Medicaid	$7,646.54

APR-DRG 36.00: CARDIAC ARREST & SHOCK

Facility

$2,074.93

Service Code	APR-DRG 1961
Min. Negotiated Rate	$1,867.59
Max. Negotiated Rate	$2,074.93
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,867.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,867.59
Rate for Payer: Managed Health Services Medicaid	$1,867.59
Rate for Payer: MDWise Medicaid	$1,867.59

APR-DRG 36.00: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$2,766.58

Service Code	APR-DRG 2012
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$2,766.58
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,501.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,501.86
Rate for Payer: Managed Health Services Medicaid	$2,501.86
Rate for Payer: MDWise Medicaid	$2,501.86

APR-DRG 36.00: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$4,106.64

Service Code	APR-DRG 2013
Min. Negotiated Rate	$3,911.36
Max. Negotiated Rate	$4,106.64
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: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$2,149.49

Service Code	APR-DRG 2011
Min. Negotiated Rate	$2,031.71
Max. Negotiated Rate	$2,149.49
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,149.49
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,149.49
Rate for Payer: Managed Health Services Medicaid	$2,149.49
Rate for Payer: MDWise Medicaid	$2,149.49

APR-DRG 36.00: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$7,521.64

Service Code	APR-DRG 2014
Min. Negotiated Rate	$4,933.25
Max. Negotiated Rate	$7,521.64
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,933.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,933.25
Rate for Payer: Managed Health Services Medicaid	$4,933.25
Rate for Payer: MDWise Medicaid	$4,933.25

APR-DRG 36.00: CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$7,046.13

Service Code	APR-DRG 1913
Min. Negotiated Rate	$4,193.26
Max. Negotiated Rate	$7,046.13
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,193.26
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,193.26
Rate for Payer: Managed Health Services Medicaid	$4,193.26
Rate for Payer: MDWise Medicaid	$4,193.26

APR-DRG 36.00: CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$4,366.01

Service Code	APR-DRG 1911
Min. Negotiated Rate	$3,136.14
Max. Negotiated Rate	$4,366.01
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: CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$10,504.36

Service Code	APR-DRG 1914
Min. Negotiated Rate	$7,681.77
Max. Negotiated Rate	$10,504.36
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,681.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,681.77
Rate for Payer: Managed Health Services Medicaid	$7,681.77
Rate for Payer: MDWise Medicaid	$7,681.77

APR-DRG 36.00: CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$5,187.34

Service Code	APR-DRG 1912
Min. Negotiated Rate	$3,699.94
Max. Negotiated Rate	$5,187.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,699.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,699.94
Rate for Payer: Managed Health Services Medicaid	$3,699.94
Rate for Payer: MDWise Medicaid	$3,699.94

APR-DRG 36.00: CARDIAC CATHETERIZATION FOR OTHER NONCORONARY CONDITIONS

Facility

$4,538.92

Service Code	APR-DRG 1921
Min. Negotiated Rate	$2,889.47
Max. Negotiated Rate	$4,538.92
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,889.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,889.47
Rate for Payer: Managed Health Services Medicaid	$2,889.47
Rate for Payer: MDWise Medicaid	$2,889.47

APR-DRG 36.00: CARDIAC CATHETERIZATION FOR OTHER NONCORONARY CONDITIONS

Facility

$13,876.12

Service Code	APR-DRG 1924
Min. Negotiated Rate	$10,254.11
Max. Negotiated Rate	$13,876.12
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,254.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,254.11
Rate for Payer: Managed Health Services Medicaid	$10,254.11
Rate for Payer: MDWise Medicaid	$10,254.11

APR-DRG 36.00: CARDIAC CATHETERIZATION FOR OTHER NONCORONARY CONDITIONS

Facility

$5,835.75

Service Code	APR-DRG 1922
Min. Negotiated Rate	$3,805.65
Max. Negotiated Rate	$5,835.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,805.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,805.65
Rate for Payer: Managed Health Services Medicaid	$3,805.65
Rate for Payer: MDWise Medicaid	$3,805.65

APR-DRG 36.00: CARDIAC CATHETERIZATION FOR OTHER NONCORONARY CONDITIONS

Facility

$8,515.88

Service Code	APR-DRG 1923
Min. Negotiated Rate	$5,673.24
Max. Negotiated Rate	$8,515.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,673.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,673.24
Rate for Payer: Managed Health Services Medicaid	$5,673.24
Rate for Payer: MDWise Medicaid	$5,673.24

APR-DRG 36.00: CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT

Facility

$58,789.81

Service Code	APR-DRG 1612
Min. Negotiated Rate	$19,239.67
Max. Negotiated Rate	$58,789.81
Rate for Payer: Anthem Blue Cross of IN Medicaid	$19,239.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$19,239.67
Rate for Payer: Managed Health Services Medicaid	$19,239.67
Rate for Payer: MDWise Medicaid	$19,239.67

APR-DRG 36.00: CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT

Facility

$79,884.97

Service Code	APR-DRG 1613
Min. Negotiated Rate	$22,587.24
Max. Negotiated Rate	$79,884.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$22,587.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$22,587.24
Rate for Payer: Managed Health Services Medicaid	$22,587.24
Rate for Payer: MDWise Medicaid	$22,587.24

APR-DRG 36.00: CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT

Facility

$102,017.61

Service Code	APR-DRG 1614
Min. Negotiated Rate	$95,458.39
Max. Negotiated Rate	$102,017.61
Rate for Payer: Anthem Blue Cross of IN Medicaid	$95,458.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$95,458.39
Rate for Payer: Managed Health Services Medicaid	$95,458.39
Rate for Payer: MDWise Medicaid	$95,458.39

Know your out-of-pocket cost for care.

All Charges