Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: CHRONIC KIDNEY DISEASE

Facility

$5,057.65

Service Code	APR-DRG 4703
Min. Negotiated Rate	$4,862.77
Max. Negotiated Rate	$5,057.65
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

$3,198.86

Service Code	APR-DRG 4702
Min. Negotiated Rate	$2,854.24
Max. Negotiated Rate	$3,198.86
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

$2,334.30

Service Code	APR-DRG 4701
Min. Negotiated Rate	$1,198.08
Max. Negotiated Rate	$2,334.30
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

$6,873.22

Service Code	APR-DRG 1404
Min. Negotiated Rate	$4,651.35
Max. Negotiated Rate	$6,873.22
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

$2,360.91

Service Code	APR-DRG 1401
Min. Negotiated Rate	$2,334.30
Max. Negotiated Rate	$2,360.91
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

$2,853.03

Service Code	APR-DRG 1402
Min. Negotiated Rate	$2,748.53
Max. Negotiated Rate	$2,853.03
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: CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$3,890.50

Service Code	APR-DRG 1403
Min. Negotiated Rate	$3,312.32
Max. Negotiated Rate	$3,890.50
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: CLEFT LIP & PALATE REPAIR

Facility

$14,438.09

Service Code	APR-DRG 0954
Min. Negotiated Rate	$3,594.22
Max. Negotiated Rate	$14,438.09
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

$4,106.64

Service Code	APR-DRG 0951
Min. Negotiated Rate	$2,431.39
Max. Negotiated Rate	$4,106.64
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

$4,366.01

Service Code	APR-DRG 0952
Min. Negotiated Rate	$2,783.76
Max. Negotiated Rate	$4,366.01
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

$6,959.68

Service Code	APR-DRG 0953
Min. Negotiated Rate	$3,594.22
Max. Negotiated Rate	$6,959.68
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

$11,346.48

Service Code	APR-DRG 6614
Min. Negotiated Rate	$11,239.23
Max. Negotiated Rate	$11,346.48
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

$3,544.68

Service Code	APR-DRG 6611
Min. Negotiated Rate	$2,748.53
Max. Negotiated Rate	$3,544.68
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

$7,046.13

Service Code	APR-DRG 6613
Min. Negotiated Rate	$4,298.98
Max. Negotiated Rate	$7,046.13
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

$4,884.74

Service Code	APR-DRG 6612
Min. Negotiated Rate	$3,382.80
Max. Negotiated Rate	$4,884.74
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

$2,031.71

Service Code	APR-DRG 7742
Min. Negotiated Rate	$1,938.06
Max. Negotiated Rate	$2,031.71
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: COCAINE ABUSE & DEPENDENCE

Facility

$1,512.97

Service Code	APR-DRG 7741
Min. Negotiated Rate	$986.65
Max. Negotiated Rate	$1,512.97
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	$3,544.68
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

$8,818.47

Service Code	APR-DRG 7744
Min. Negotiated Rate	$5,778.95
Max. Negotiated Rate	$8,818.47
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: CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA

Facility

$3,069.17

Service Code	APR-DRG 0571
Min. Negotiated Rate	$1,938.06
Max. Negotiated Rate	$3,069.17
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

$4,409.24

Service Code	APR-DRG 0572
Min. Negotiated Rate	$3,136.14
Max. Negotiated Rate	$4,409.24
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: CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA

Facility

$6,181.58

Service Code	APR-DRG 0573
Min. Negotiated Rate	$3,594.22
Max. Negotiated Rate	$6,181.58
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: CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA

Facility

$10,417.90

Service Code	APR-DRG 0574
Min. Negotiated Rate	$6,237.04
Max. Negotiated Rate	$10,417.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,237.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,237.04
Rate for Payer: Managed Health Services Medicaid	$6,237.04
Rate for Payer: MDWise Medicaid	$6,237.04

APR-DRG 36.00: CONNECTIVE TISSUE DISORDERS

Facility

$7,175.81

Service Code	APR-DRG 3463
Min. Negotiated Rate	$4,439.93
Max. Negotiated Rate	$7,175.81
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,439.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,439.93
Rate for Payer: Managed Health Services Medicaid	$4,439.93
Rate for Payer: MDWise Medicaid	$4,439.93

APR-DRG 36.00: CONNECTIVE TISSUE DISORDERS

Facility

$13,141.25

Service Code	APR-DRG 3464
Min. Negotiated Rate	$9,690.31
Max. Negotiated Rate	$13,141.25
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,690.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,690.31
Rate for Payer: Managed Health Services Medicaid	$9,690.31
Rate for Payer: MDWise Medicaid	$9,690.31

Know your out-of-pocket cost for care.

All Charges