Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: DIGESTIVE MALIGNANCY

Facility

$6,268.03

Service Code	APR-DRG 2403
Min. Negotiated Rate	$5,038.96
Max. Negotiated Rate	$6,268.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,038.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,038.96
Rate for Payer: Managed Health Services Medicaid	$5,038.96
Rate for Payer: MDWise Medicaid	$5,038.96

APR-DRG 36.00: DIGESTIVE MALIGNANCY

Facility

$9,985.62

Service Code	APR-DRG 2404
Min. Negotiated Rate	$8,175.10
Max. Negotiated Rate	$9,985.62
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,175.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,175.10
Rate for Payer: Managed Health Services Medicaid	$8,175.10
Rate for Payer: MDWise Medicaid	$8,175.10

APR-DRG 36.00: DIGESTIVE MALIGNANCY

Facility

$4,510.40

Service Code	APR-DRG 2402
Min. Negotiated Rate	$4,279.55
Max. Negotiated Rate	$4,510.40
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,510.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,510.40
Rate for Payer: Managed Health Services Medicaid	$4,510.40
Rate for Payer: MDWise Medicaid	$4,510.40

APR-DRG 36.00: DIGESTIVE MALIGNANCY

Facility

$4,510.40

Service Code	APR-DRG 2401
Min. Negotiated Rate	$3,458.22
Max. Negotiated Rate	$4,510.40
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,510.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,510.40
Rate for Payer: Managed Health Services Medicaid	$4,510.40
Rate for Payer: MDWise Medicaid	$4,510.40

APR-DRG 36.00: DILATION & CURETTAGE FOR NONOBSTETRIC DIAGNOSES

Facility

$3,587.91

Service Code	APR-DRG 5171
Min. Negotiated Rate	$2,607.57
Max. Negotiated Rate	$3,587.91
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,607.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,607.57
Rate for Payer: Managed Health Services Medicaid	$2,607.57
Rate for Payer: MDWise Medicaid	$2,607.57

APR-DRG 36.00: DILATION & CURETTAGE FOR NONOBSTETRIC DIAGNOSES

Facility

$7,305.50

Service Code	APR-DRG 5173
Min. Negotiated Rate	$7,188.45
Max. Negotiated Rate	$7,305.50
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,188.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,188.45
Rate for Payer: Managed Health Services Medicaid	$7,188.45
Rate for Payer: MDWise Medicaid	$7,188.45

APR-DRG 36.00: DILATION & CURETTAGE FOR NONOBSTETRIC DIAGNOSES

Facility

$4,884.74

Service Code	APR-DRG 5172
Min. Negotiated Rate	$2,889.47
Max. Negotiated Rate	$4,884.74
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,889.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,889.47
Rate for Payer: Managed Health Services Medicaid	$2,889.47
Rate for Payer: MDWise Medicaid	$2,889.47

APR-DRG 36.00: DILATION & CURETTAGE FOR NONOBSTETRIC DIAGNOSES

Facility

$11,196.00

Service Code	APR-DRG 5174
Min. Negotiated Rate	$8,985.56
Max. Negotiated Rate	$11,196.00
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,985.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,985.56
Rate for Payer: Managed Health Services Medicaid	$8,985.56
Rate for Payer: MDWise Medicaid	$8,985.56

APR-DRG 36.00: DISORDERS OF GALLBLADDER & BILIARY TRACT

Facility

$4,193.10

Service Code	APR-DRG 2842
Min. Negotiated Rate	$3,840.89
Max. Negotiated Rate	$4,193.10
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: DISORDERS OF GALLBLADDER & BILIARY TRACT

Facility

$9,726.25

Service Code	APR-DRG 2844
Min. Negotiated Rate	$6,060.85
Max. Negotiated Rate	$9,726.25
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,060.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,060.85
Rate for Payer: Managed Health Services Medicaid	$6,060.85
Rate for Payer: MDWise Medicaid	$6,060.85

APR-DRG 36.00: DISORDERS OF GALLBLADDER & BILIARY TRACT

Facility

$3,241.85

Service Code	APR-DRG 2841
Min. Negotiated Rate	$3,112.40
Max. Negotiated Rate	$3,241.85
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,241.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,241.85
Rate for Payer: Managed Health Services Medicaid	$3,241.85
Rate for Payer: MDWise Medicaid	$3,241.85

APR-DRG 36.00: DISORDERS OF GALLBLADDER & BILIARY TRACT

Facility

$5,792.53

Service Code	APR-DRG 2843
Min. Negotiated Rate	$4,228.50
Max. Negotiated Rate	$5,792.53
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,228.50
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,228.50
Rate for Payer: Managed Health Services Medicaid	$4,228.50
Rate for Payer: MDWise Medicaid	$4,228.50

APR-DRG 36.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$2,377.53

Service Code	APR-DRG 2821
Min. Negotiated Rate	$2,360.91
Max. Negotiated Rate	$2,377.53
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: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$11,945.51

Service Code	APR-DRG 2824
Min. Negotiated Rate	$11,368.91
Max. Negotiated Rate	$11,945.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,945.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,945.51
Rate for Payer: Managed Health Services Medicaid	$11,945.51
Rate for Payer: MDWise Medicaid	$11,945.51

APR-DRG 36.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$3,285.31

Service Code	APR-DRG 2822
Min. Negotiated Rate	$2,889.47
Max. Negotiated Rate	$3,285.31
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,889.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,889.47
Rate for Payer: Managed Health Services Medicaid	$2,889.47
Rate for Payer: MDWise Medicaid	$2,889.47

APR-DRG 36.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$5,360.25

Service Code	APR-DRG 2823
Min. Negotiated Rate	$4,721.82
Max. Negotiated Rate	$5,360.25
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,721.82
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,721.82
Rate for Payer: Managed Health Services Medicaid	$4,721.82
Rate for Payer: MDWise Medicaid	$4,721.82

APR-DRG 36.00: DIVERTICULITIS & DIVERTICULOSIS

Facility

$15,257.84

Service Code	APR-DRG 2444
Min. Negotiated Rate	$9,034.61
Max. Negotiated Rate	$15,257.84
Rate for Payer: Anthem Blue Cross of IN Medicaid	$15,257.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$15,257.84
Rate for Payer: Managed Health Services Medicaid	$15,257.84
Rate for Payer: MDWise Medicaid	$15,257.84

APR-DRG 36.00: DIVERTICULITIS & DIVERTICULOSIS

Facility

$2,819.00

Service Code	APR-DRG 2441
Min. Negotiated Rate	$2,291.07
Max. Negotiated Rate	$2,819.00
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,819.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,819.00
Rate for Payer: Managed Health Services Medicaid	$2,819.00
Rate for Payer: MDWise Medicaid	$2,819.00

APR-DRG 36.00: DIVERTICULITIS & DIVERTICULOSIS

Facility

$3,155.63

Service Code	APR-DRG 2442
Min. Negotiated Rate	$2,959.95
Max. Negotiated Rate	$3,155.63
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: DIVERTICULITIS & DIVERTICULOSIS

Facility

$4,927.97

Service Code	APR-DRG 2443
Min. Negotiated Rate	$2,995.19
Max. Negotiated Rate	$4,927.97
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: DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK

Facility

$27,622.56

Service Code	APR-DRG 3044
Min. Negotiated Rate	$23,291.99
Max. Negotiated Rate	$27,622.56
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,291.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,291.99
Rate for Payer: Managed Health Services Medicaid	$23,291.99
Rate for Payer: MDWise Medicaid	$23,291.99

APR-DRG 36.00: DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK

Facility

$13,002.64

Service Code	APR-DRG 3041
Min. Negotiated Rate	$10,720.49
Max. Negotiated Rate	$13,002.64
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,002.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,002.64
Rate for Payer: Managed Health Services Medicaid	$13,002.64
Rate for Payer: MDWise Medicaid	$13,002.64

APR-DRG 36.00: DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK

Facility

$15,363.55

Service Code	APR-DRG 3042
Min. Negotiated Rate	$14,611.00
Max. Negotiated Rate	$15,363.55
Rate for Payer: Anthem Blue Cross of IN Medicaid	$15,363.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$15,363.55
Rate for Payer: Managed Health Services Medicaid	$15,363.55
Rate for Payer: MDWise Medicaid	$15,363.55

APR-DRG 36.00: DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK

Facility

$20,472.99

Service Code	APR-DRG 3043
Min. Negotiated Rate	$20,360.29
Max. Negotiated Rate	$20,472.99
Rate for Payer: Anthem Blue Cross of IN Medicaid	$20,472.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$20,472.99
Rate for Payer: Managed Health Services Medicaid	$20,472.99
Rate for Payer: MDWise Medicaid	$20,472.99

APR-DRG 36.00: DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK

Facility

$28,154.76

Service Code	APR-DRG 3033
Min. Negotiated Rate	$27,190.29
Max. Negotiated Rate	$28,154.76
Rate for Payer: Anthem Blue Cross of IN Medicaid	$28,154.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$28,154.76
Rate for Payer: Managed Health Services Medicaid	$28,154.76
Rate for Payer: MDWise Medicaid	$28,154.76

Know your out-of-pocket cost for care.

All Charges