Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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 PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility

$7,564.86

Service Code	APR-DRG 1761
Min. Negotiated Rate	$6,483.70
Max. Negotiated Rate	$7,564.86
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

$18,957.78

Service Code	APR-DRG 1763
Min. Negotiated Rate	$13,832.90
Max. Negotiated Rate	$18,957.78
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

$10,288.22

Service Code	APR-DRG 1762
Min. Negotiated Rate	$6,554.18
Max. Negotiated Rate	$10,288.22
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

$19,538.97

Service Code	APR-DRG 1764
Min. Negotiated Rate	$18,957.78
Max. Negotiated Rate	$19,538.97
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

$5,749.30

Service Code	APR-DRG 1771
Min. Negotiated Rate	$3,805.65
Max. Negotiated Rate	$5,749.30
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

$15,605.24

Service Code	APR-DRG 1774
Min. Negotiated Rate	$10,430.30
Max. Negotiated Rate	$15,605.24
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

$8,732.02

Service Code	APR-DRG 1772
Min. Negotiated Rate	$6,166.56
Max. Negotiated Rate	$8,732.02
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

$10,893.41

Service Code	APR-DRG 1773
Min. Negotiated Rate	$10,430.30
Max. Negotiated Rate	$10,893.41
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 2003
Min. Negotiated Rate	$5,619.61
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

$9,899.17

Service Code	APR-DRG 2004
Min. Negotiated Rate	$5,743.71
Max. Negotiated Rate	$9,899.17
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 2001
Min. Negotiated Rate	$2,853.03
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

$5,743.71

Service Code	APR-DRG 2002
Min. Negotiated Rate	$3,804.05
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 VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility

$18,112.45

Service Code	APR-DRG 1621
Min. Negotiated Rate	$13,073.11
Max. Negotiated Rate	$18,112.45
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

$21,743.58

Service Code	APR-DRG 1622
Min. Negotiated Rate	$15,222.60
Max. Negotiated Rate	$21,743.58
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 AMI OR COMPLEX PDX

Facility

$28,789.71

Service Code	APR-DRG 1623
Min. Negotiated Rate	$23,186.28
Max. Negotiated Rate	$28,789.71
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

$39,337.30

Service Code	APR-DRG 1624
Min. Negotiated Rate	$32,242.31
Max. Negotiated Rate	$39,337.30
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/O AMI OR COMPLEX PDX

Facility

$18,285.36

Service Code	APR-DRG 1632
Min. Negotiated Rate	$14,764.51
Max. Negotiated Rate	$18,285.36
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

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

Facility

$15,302.64

Service Code	APR-DRG 1631
Min. Negotiated Rate	$11,135.05
Max. Negotiated Rate	$15,302.64
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

$24,769.53

Service Code	APR-DRG 1633
Min. Negotiated Rate	$16,314.96
Max. Negotiated Rate	$24,769.53
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

$34,452.56

Service Code	APR-DRG 1634
Min. Negotiated Rate	$28,225.24
Max. Negotiated Rate	$34,452.56
Rate for Payer: Anthem Blue Cross of IN Medicaid	$28,225.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$28,225.24
Rate for Payer: Managed Health Services Medicaid	$28,225.24
Rate for Payer: MDWise Medicaid	$28,225.24

APR-DRG 36.00: CARDIOMYOPATHY

Facility

$3,112.40

Service Code	APR-DRG 2052
Min. Negotiated Rate	$1,867.59
Max. Negotiated Rate	$3,112.40
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: CARDIOMYOPATHY

Facility

$4,927.97

Service Code	APR-DRG 2053
Min. Negotiated Rate	$2,959.95
Max. Negotiated Rate	$4,927.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,959.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,959.95
Rate for Payer: Managed Health Services Medicaid	$2,959.95
Rate for Payer: MDWise Medicaid	$2,959.95

APR-DRG 36.00: CARDIOMYOPATHY

Facility

$2,507.21

Service Code	APR-DRG 2051
Min. Negotiated Rate	$1,867.59
Max. Negotiated Rate	$2,507.21
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: CARDIOMYOPATHY

Facility

$9,207.52

Service Code	APR-DRG 2054
Min. Negotiated Rate	$4,827.54
Max. Negotiated Rate	$9,207.52
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,827.54
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,827.54
Rate for Payer: Managed Health Services Medicaid	$4,827.54
Rate for Payer: MDWise Medicaid	$4,827.54

Know your out-of-pocket cost for care.

All Charges