Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: CHOLECYSTECTOMY

Facility

$16,210.42

Service Code	APR-DRG 2634
Min. Negotiated Rate	$14,306.42
Max. Negotiated Rate	$16,210.42
Rate for Payer: Anthem Blue Cross of IN Medicaid	$14,306.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$14,306.42
Rate for Payer: Managed Health Services Medicaid	$14,306.42
Rate for Payer: MDWise Medicaid	$14,306.42

APR-DRG 36.00: CHOLECYSTECTOMY

Facility

$7,002.90

Service Code	APR-DRG 2632
Min. Negotiated Rate	$5,144.68
Max. Negotiated Rate	$7,002.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,144.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,144.68
Rate for Payer: Managed Health Services Medicaid	$5,144.68
Rate for Payer: MDWise Medicaid	$5,144.68

APR-DRG 36.00: CHOLECYSTECTOMY

Facility

$5,662.84

Service Code	APR-DRG 2631
Min. Negotiated Rate	$4,122.79
Max. Negotiated Rate	$5,662.84
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,122.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,122.79
Rate for Payer: Managed Health Services Medicaid	$4,122.79
Rate for Payer: MDWise Medicaid	$4,122.79

APR-DRG 36.00: CHOLECYSTECTOMY

Facility

$9,639.80

Service Code	APR-DRG 2633
Min. Negotiated Rate	$5,743.71
Max. Negotiated Rate	$9,639.80
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: CHRONIC KIDNEY DISEASE

Facility

$5,489.93

Service Code	APR-DRG 4703
Min. Negotiated Rate	$4,862.77
Max. Negotiated Rate	$5,489.93
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,862.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,862.77
Rate for Payer: Managed Health Services Medicaid	$4,862.77
Rate for Payer: MDWise Medicaid	$4,862.77

APR-DRG 36.00: CHRONIC KIDNEY DISEASE

Facility

$9,985.62

Service Code	APR-DRG 4704
Min. Negotiated Rate	$5,391.34
Max. Negotiated Rate	$9,985.62
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: CHRONIC KIDNEY DISEASE

Facility

$3,501.45

Service Code	APR-DRG 4702
Min. Negotiated Rate	$2,854.24
Max. Negotiated Rate	$3,501.45
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,854.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,854.24
Rate for Payer: Managed Health Services Medicaid	$2,854.24
Rate for Payer: MDWise Medicaid	$2,854.24

APR-DRG 36.00: CHRONIC KIDNEY DISEASE

Facility

$2,550.44

Service Code	APR-DRG 4701
Min. Negotiated Rate	$1,198.08
Max. Negotiated Rate	$2,550.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,198.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,198.08
Rate for Payer: Managed Health Services Medicaid	$1,198.08
Rate for Payer: MDWise Medicaid	$1,198.08

APR-DRG 36.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$2,939.49

Service Code	APR-DRG 1401
Min. Negotiated Rate	$2,360.91
Max. Negotiated Rate	$2,939.49
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,360.91
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,360.91
Rate for Payer: Managed Health Services Medicaid	$2,360.91
Rate for Payer: MDWise Medicaid	$2,360.91

APR-DRG 36.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$6,743.54

Service Code	APR-DRG 1404
Min. Negotiated Rate	$4,651.35
Max. Negotiated Rate	$6,743.54
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,651.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,651.35
Rate for Payer: Managed Health Services Medicaid	$4,651.35
Rate for Payer: MDWise Medicaid	$4,651.35

APR-DRG 36.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$4,236.32

Service Code	APR-DRG 1403
Min. Negotiated Rate	$3,312.32
Max. Negotiated Rate	$4,236.32
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,312.32
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,312.32
Rate for Payer: Managed Health Services Medicaid	$3,312.32
Rate for Payer: MDWise Medicaid	$3,312.32

APR-DRG 36.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$3,371.77

Service Code	APR-DRG 1402
Min. Negotiated Rate	$2,748.53
Max. Negotiated Rate	$3,371.77
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,748.53
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,748.53
Rate for Payer: Managed Health Services Medicaid	$2,748.53
Rate for Payer: MDWise Medicaid	$2,748.53

APR-DRG 36.00: CLEFT LIP & PALATE REPAIR

Facility

$7,608.09

Service Code	APR-DRG 0952
Min. Negotiated Rate	$2,783.76
Max. Negotiated Rate	$7,608.09
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,783.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,783.76
Rate for Payer: Managed Health Services Medicaid	$2,783.76
Rate for Payer: MDWise Medicaid	$2,783.76

APR-DRG 36.00: CLEFT LIP & PALATE REPAIR

Facility

$8,342.97

Service Code	APR-DRG 0953
Min. Negotiated Rate	$3,594.22
Max. Negotiated Rate	$8,342.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,594.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,594.22
Rate for Payer: Managed Health Services Medicaid	$3,594.22
Rate for Payer: MDWise Medicaid	$3,594.22

APR-DRG 36.00: CLEFT LIP & PALATE REPAIR

Facility

$6,268.03

Service Code	APR-DRG 0951
Min. Negotiated Rate	$2,431.39
Max. Negotiated Rate	$6,268.03
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: CLEFT LIP & PALATE REPAIR

Facility

$17,464.03

Service Code	APR-DRG 0954
Min. Negotiated Rate	$3,594.22
Max. Negotiated Rate	$17,464.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,594.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,594.22
Rate for Payer: Managed Health Services Medicaid	$3,594.22
Rate for Payer: MDWise Medicaid	$3,594.22

APR-DRG 36.00: COAGULATION & PLATELET DISORDERS

Facility

$3,501.45

Service Code	APR-DRG 6611
Min. Negotiated Rate	$2,748.53
Max. Negotiated Rate	$3,501.45
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,748.53
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,748.53
Rate for Payer: Managed Health Services Medicaid	$2,748.53
Rate for Payer: MDWise Medicaid	$2,748.53

APR-DRG 36.00: COAGULATION & PLATELET DISORDERS

Facility

$12,190.24

Service Code	APR-DRG 6613
Min. Negotiated Rate	$4,298.98
Max. Negotiated Rate	$12,190.24
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,298.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,298.98
Rate for Payer: Managed Health Services Medicaid	$4,298.98
Rate for Payer: MDWise Medicaid	$4,298.98

APR-DRG 36.00: COAGULATION & PLATELET DISORDERS

Facility

$18,847.32

Service Code	APR-DRG 6614
Min. Negotiated Rate	$11,346.48
Max. Negotiated Rate	$18,847.32
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,346.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,346.48
Rate for Payer: Managed Health Services Medicaid	$11,346.48
Rate for Payer: MDWise Medicaid	$11,346.48

APR-DRG 36.00: COAGULATION & PLATELET DISORDERS

Facility

$5,662.84

Service Code	APR-DRG 6612
Min. Negotiated Rate	$3,382.80
Max. Negotiated Rate	$5,662.84
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,382.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,382.80
Rate for Payer: Managed Health Services Medicaid	$3,382.80
Rate for Payer: MDWise Medicaid	$3,382.80

APR-DRG 36.00: COCAINE ABUSE & DEPENDENCE

Facility

$2,118.16

Service Code	APR-DRG 7741
Min. Negotiated Rate	$986.65
Max. Negotiated Rate	$2,118.16
Rate for Payer: Anthem Blue Cross of IN Medicaid	$986.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$986.65
Rate for Payer: Managed Health Services Medicaid	$986.65
Rate for Payer: MDWise Medicaid	$986.65

APR-DRG 36.00: COCAINE ABUSE & DEPENDENCE

Facility

$3,840.89

Service Code	APR-DRG 7743
Min. Negotiated Rate	$3,717.59
Max. Negotiated Rate	$3,840.89
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,840.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,840.89
Rate for Payer: Managed Health Services Medicaid	$3,840.89
Rate for Payer: MDWise Medicaid	$3,840.89

APR-DRG 36.00: COCAINE ABUSE & DEPENDENCE

Facility

$9,121.07

Service Code	APR-DRG 7744
Min. Negotiated Rate	$5,778.95
Max. Negotiated Rate	$9,121.07
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,778.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,778.95
Rate for Payer: Managed Health Services Medicaid	$5,778.95
Rate for Payer: MDWise Medicaid	$5,778.95

APR-DRG 36.00: COCAINE ABUSE & DEPENDENCE

Facility

$2,853.03

Service Code	APR-DRG 7742
Min. Negotiated Rate	$1,938.06
Max. Negotiated Rate	$2,853.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,938.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,938.06
Rate for Payer: Managed Health Services Medicaid	$1,938.06
Rate for Payer: MDWise Medicaid	$1,938.06

APR-DRG 36.00: CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA

Facility

$2,463.98

Service Code	APR-DRG 0571
Min. Negotiated Rate	$1,938.06
Max. Negotiated Rate	$2,463.98
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,938.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,938.06
Rate for Payer: Managed Health Services Medicaid	$1,938.06
Rate for Payer: MDWise Medicaid	$1,938.06

Know your out-of-pocket cost for care.

All Charges