Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

APR-DRG 36.00: CARDIAC CATHETERIZATION FOR OTHER NONCORONARY CONDITIONS

Facility

$8,083.60

Service Code	APR-DRG 1923
Min. Negotiated Rate	$5,673.24
Max. Negotiated Rate	$8,083.60
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

$64,193.28

Service Code	APR-DRG 1612
Min. Negotiated Rate	$19,239.67
Max. Negotiated Rate	$64,193.28
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

$55,850.32

Service Code	APR-DRG 1611
Min. Negotiated Rate	$15,680.69
Max. Negotiated Rate	$55,850.32
Rate for Payer: Anthem Blue Cross of IN Medicaid	$15,680.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$15,680.69
Rate for Payer: Managed Health Services Medicaid	$15,680.69
Rate for Payer: MDWise Medicaid	$15,680.69

APR-DRG 36.00: CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT

Facility

$72,968.53

Service Code	APR-DRG 1613
Min. Negotiated Rate	$22,587.24
Max. Negotiated Rate	$72,968.53
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

$121,297.21

Service Code	APR-DRG 1614
Min. Negotiated Rate	$95,458.39
Max. Negotiated Rate	$121,297.21
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

APR-DRG 36.00: CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility

$7,910.69

Service Code	APR-DRG 1761
Min. Negotiated Rate	$6,483.70
Max. Negotiated Rate	$7,910.69
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,483.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,483.70
Rate for Payer: Managed Health Services Medicaid	$6,483.70
Rate for Payer: MDWise Medicaid	$6,483.70

APR-DRG 36.00: CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility

$16,599.48

Service Code	APR-DRG 1762
Min. Negotiated Rate	$6,554.18
Max. Negotiated Rate	$16,599.48
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,554.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,554.18
Rate for Payer: Managed Health Services Medicaid	$6,554.18
Rate for Payer: MDWise Medicaid	$6,554.18

APR-DRG 36.00: CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility

$29,394.90

Service Code	APR-DRG 1764
Min. Negotiated Rate	$18,957.78
Max. Negotiated Rate	$29,394.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,957.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,957.78
Rate for Payer: Managed Health Services Medicaid	$18,957.78
Rate for Payer: MDWise Medicaid	$18,957.78

APR-DRG 36.00: CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility

$20,317.07

Service Code	APR-DRG 1763
Min. Negotiated Rate	$18,957.78
Max. Negotiated Rate	$20,317.07
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,957.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,957.78
Rate for Payer: Managed Health Services Medicaid	$18,957.78
Rate for Payer: MDWise Medicaid	$18,957.78

APR-DRG 36.00: CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$16,772.39

Service Code	APR-DRG 1774
Min. Negotiated Rate	$10,430.30
Max. Negotiated Rate	$16,772.39
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,430.30
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,430.30
Rate for Payer: Managed Health Services Medicaid	$10,430.30
Rate for Payer: MDWise Medicaid	$10,430.30

APR-DRG 36.00: CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$6,570.63

Service Code	APR-DRG 1771
Min. Negotiated Rate	$3,805.65
Max. Negotiated Rate	$6,570.63
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 PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$9,553.34

Service Code	APR-DRG 1772
Min. Negotiated Rate	$6,166.56
Max. Negotiated Rate	$9,553.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,166.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,166.56
Rate for Payer: Managed Health Services Medicaid	$6,166.56
Rate for Payer: MDWise Medicaid	$6,166.56

APR-DRG 36.00: CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$13,227.71

Service Code	APR-DRG 1773
Min. Negotiated Rate	$10,430.30
Max. Negotiated Rate	$13,227.71
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,430.30
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,430.30
Rate for Payer: Managed Health Services Medicaid	$10,430.30
Rate for Payer: MDWise Medicaid	$10,430.30

APR-DRG 36.00: CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$5,743.71

Service Code	APR-DRG 2001
Min. Negotiated Rate	$3,112.40
Max. Negotiated Rate	$5,743.71
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,743.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,743.71
Rate for Payer: Managed Health Services Medicaid	$5,743.71
Rate for Payer: MDWise Medicaid	$5,743.71

APR-DRG 36.00: CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$15,907.83

Service Code	APR-DRG 2004
Min. Negotiated Rate	$5,743.71
Max. Negotiated Rate	$15,907.83
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,743.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,743.71
Rate for Payer: Managed Health Services Medicaid	$5,743.71
Rate for Payer: MDWise Medicaid	$5,743.71

APR-DRG 36.00: CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$5,743.71

Service Code	APR-DRG 2002
Min. Negotiated Rate	$4,279.55
Max. Negotiated Rate	$5,743.71
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,743.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,743.71
Rate for Payer: Managed Health Services Medicaid	$5,743.71
Rate for Payer: MDWise Medicaid	$5,743.71

APR-DRG 36.00: CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$8,904.93

Service Code	APR-DRG 2003
Min. Negotiated Rate	$5,743.71
Max. Negotiated Rate	$8,904.93
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,743.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,743.71
Rate for Payer: Managed Health Services Medicaid	$5,743.71
Rate for Payer: MDWise Medicaid	$5,743.71

APR-DRG 36.00: CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$20,879.03

Service Code	APR-DRG 1621
Min. Negotiated Rate	$13,073.11
Max. Negotiated Rate	$20,879.03
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: CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$30,259.46

Service Code	APR-DRG 1623
Min. Negotiated Rate	$23,186.28
Max. Negotiated Rate	$30,259.46
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,186.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,186.28
Rate for Payer: Managed Health Services Medicaid	$23,186.28
Rate for Payer: MDWise Medicaid	$23,186.28

APR-DRG 36.00: CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$38,688.88

Service Code	APR-DRG 1624
Min. Negotiated Rate	$32,242.31
Max. Negotiated Rate	$38,688.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$32,242.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$32,242.31
Rate for Payer: Managed Health Services Medicaid	$32,242.31
Rate for Payer: MDWise Medicaid	$32,242.31

APR-DRG 36.00: CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$25,115.35

Service Code	APR-DRG 1622
Min. Negotiated Rate	$15,222.60
Max. Negotiated Rate	$25,115.35
Rate for Payer: Anthem Blue Cross of IN Medicaid	$15,222.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$15,222.60
Rate for Payer: Managed Health Services Medicaid	$15,222.60
Rate for Payer: MDWise Medicaid	$15,222.60

APR-DRG 36.00: CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility

$24,942.44

Service Code	APR-DRG 1633
Min. Negotiated Rate	$16,314.96
Max. Negotiated Rate	$24,942.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$16,314.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$16,314.96
Rate for Payer: Managed Health Services Medicaid	$16,314.96
Rate for Payer: MDWise Medicaid	$16,314.96

APR-DRG 36.00: CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility

$17,031.75

Service Code	APR-DRG 1631
Min. Negotiated Rate	$11,135.05
Max. Negotiated Rate	$17,031.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,135.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,135.05
Rate for Payer: Managed Health Services Medicaid	$11,135.05
Rate for Payer: MDWise Medicaid	$11,135.05

APR-DRG 36.00: CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility

$18,587.95

Service Code	APR-DRG 1632
Min. Negotiated Rate	$14,764.51
Max. Negotiated Rate	$18,587.95
Rate for Payer: Anthem Blue Cross of IN Medicaid	$14,764.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$14,764.51
Rate for Payer: Managed Health Services Medicaid	$14,764.51
Rate for Payer: MDWise Medicaid	$14,764.51

Know your out-of-pocket cost for care.

All Charges