Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$4,149.87

Service Code	APR-DRG 0562
Min. Negotiated Rate	$2,713.29
Max. Negotiated Rate	$4,149.87
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

$6,959.68

Service Code	APR-DRG 0563
Min. Negotiated Rate	$2,713.29
Max. Negotiated Rate	$6,959.68
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

$8,299.74

Service Code	APR-DRG 0564
Min. Negotiated Rate	$2,713.29
Max. Negotiated Rate	$8,299.74
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

$6,268.03

Service Code	APR-DRG 3631
Min. Negotiated Rate	$4,334.21
Max. Negotiated Rate	$6,268.03
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

$9,034.61

Service Code	APR-DRG 3632
Min. Negotiated Rate	$7,857.96
Max. Negotiated Rate	$9,034.61
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

APR-DRG 36.00: BREAST PROCEDURES EXCEPT MASTECTOMY

Facility

$13,141.25

Service Code	APR-DRG 3633
Min. Negotiated Rate	$9,478.89
Max. Negotiated Rate	$13,141.25
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

$14,394.86

Service Code	APR-DRG 3634
Min. Negotiated Rate	$10,853.15
Max. Negotiated Rate	$14,394.86
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

$4,971.20

Service Code	APR-DRG 1383
Min. Negotiated Rate	$3,347.56
Max. Negotiated Rate	$4,971.20
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: BRONCHIOLITIS & RSV PNEUMONIA

Facility

$2,334.30

Service Code	APR-DRG 1381
Min. Negotiated Rate	$1,726.64
Max. Negotiated Rate	$2,334.30
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

$6,730.36

Service Code	APR-DRG 1384
Min. Negotiated Rate	$6,700.31
Max. Negotiated Rate	$6,730.36
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

$3,328.54

Service Code	APR-DRG 1382
Min. Negotiated Rate	$2,396.15
Max. Negotiated Rate	$3,328.54
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: CARDIAC ARREST & SHOCK

Facility

$2,723.35

Service Code	APR-DRG 1962
Min. Negotiated Rate	$1,867.59
Max. Negotiated Rate	$2,723.35
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

$10,893.41

Service Code	APR-DRG 1964
Min. Negotiated Rate	$7,646.54
Max. Negotiated Rate	$10,893.41
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

$1,867.59

Service Code	APR-DRG 1961
Min. Negotiated Rate	$1,512.97
Max. Negotiated Rate	$1,867.59
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

$6,051.89

Service Code	APR-DRG 1963
Min. Negotiated Rate	$2,995.19
Max. Negotiated Rate	$6,051.89
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 ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$3,198.86

Service Code	APR-DRG 2012
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$3,198.86
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

$7,737.78

Service Code	APR-DRG 2014
Min. Negotiated Rate	$4,933.25
Max. Negotiated Rate	$7,737.78
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 ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$2,377.53

Service Code	APR-DRG 2011
Min. Negotiated Rate	$2,149.49
Max. Negotiated Rate	$2,377.53
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

$4,495.69

Service Code	APR-DRG 2013
Min. Negotiated Rate	$3,911.36
Max. Negotiated Rate	$4,495.69
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 CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$4,020.19

Service Code	APR-DRG 1911
Min. Negotiated Rate	$3,136.14
Max. Negotiated Rate	$4,020.19
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

$8,861.70

Service Code	APR-DRG 1914
Min. Negotiated Rate	$7,681.77
Max. Negotiated Rate	$8,861.70
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

$5,057.65

Service Code	APR-DRG 1912
Min. Negotiated Rate	$3,699.94
Max. Negotiated Rate	$5,057.65
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 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 OTHER NONCORONARY CONDITIONS

Facility

$13,270.93

Service Code	APR-DRG 1924
Min. Negotiated Rate	$10,254.11
Max. Negotiated Rate	$13,270.93
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

$6,440.94

Service Code	APR-DRG 1922
Min. Negotiated Rate	$3,805.65
Max. Negotiated Rate	$6,440.94
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

Know your out-of-pocket cost for care.

All Charges