Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$28,154.76

Service Code	APR-DRG 3031
Min. Negotiated Rate	$17,118.21
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

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

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

Facility

$28,154.76

Service Code	APR-DRG 3032
Min. Negotiated Rate	$19,755.10
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

APR-DRG 36.00: DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$1,902.02

Service Code	APR-DRG 7702
Min. Negotiated Rate	$1,092.36
Max. Negotiated Rate	$1,902.02
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,092.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,092.36
Rate for Payer: Managed Health Services Medicaid	$1,092.36
Rate for Payer: MDWise Medicaid	$1,092.36

APR-DRG 36.00: DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$6,959.68

Service Code	APR-DRG 7704
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$6,959.68
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,501.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,501.86
Rate for Payer: Managed Health Services Medicaid	$2,501.86
Rate for Payer: MDWise Medicaid	$2,501.86

APR-DRG 36.00: DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$1,210.38

Service Code	APR-DRG 7701
Min. Negotiated Rate	$810.46
Max. Negotiated Rate	$1,210.38
Rate for Payer: Anthem Blue Cross of IN Medicaid	$810.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$810.46
Rate for Payer: Managed Health Services Medicaid	$810.46
Rate for Payer: MDWise Medicaid	$810.46

APR-DRG 36.00: DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE

Facility

$3,242.09

Service Code	APR-DRG 7703
Min. Negotiated Rate	$1,691.40
Max. Negotiated Rate	$3,242.09
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,691.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,691.40
Rate for Payer: Managed Health Services Medicaid	$1,691.40
Rate for Payer: MDWise Medicaid	$1,691.40

APR-DRG 36.00: EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES

Facility

$4,020.19

Service Code	APR-DRG 1101
Min. Negotiated Rate	$2,184.72
Max. Negotiated Rate	$4,020.19
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,184.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,184.72
Rate for Payer: Managed Health Services Medicaid	$2,184.72
Rate for Payer: MDWise Medicaid	$2,184.72

APR-DRG 36.00: EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES

Facility

$4,582.15

Service Code	APR-DRG 1102
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$4,582.15
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,678.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,678.05
Rate for Payer: Managed Health Services Medicaid	$2,678.05
Rate for Payer: MDWise Medicaid	$2,678.05

APR-DRG 36.00: EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES

Facility

$10,806.95

Service Code	APR-DRG 1104
Min. Negotiated Rate	$6,906.55
Max. Negotiated Rate	$10,806.95
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,906.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,906.55
Rate for Payer: Managed Health Services Medicaid	$6,906.55
Rate for Payer: MDWise Medicaid	$6,906.55

APR-DRG 36.00: EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES

Facility

$6,311.26

Service Code	APR-DRG 1103
Min. Negotiated Rate	$4,052.31
Max. Negotiated Rate	$6,311.26
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,052.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,052.31
Rate for Payer: Managed Health Services Medicaid	$4,052.31
Rate for Payer: MDWise Medicaid	$4,052.31

APR-DRG 36.00: ECTOPIC PREGNANCY PROCEDURE

Facility

$4,263.74

Service Code	APR-DRG 5453
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$4,263.74
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,263.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,263.74
Rate for Payer: Managed Health Services Medicaid	$4,263.74
Rate for Payer: MDWise Medicaid	$4,263.74

APR-DRG 36.00: ECTOPIC PREGNANCY PROCEDURE

Facility

$4,263.74

Service Code	APR-DRG 5454
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$4,263.74
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,263.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,263.74
Rate for Payer: Managed Health Services Medicaid	$4,263.74
Rate for Payer: MDWise Medicaid	$4,263.74

APR-DRG 36.00: ECTOPIC PREGNANCY PROCEDURE

Facility

$2,995.19

Service Code	APR-DRG 5451
Min. Negotiated Rate	$2,995.19
Max. Negotiated Rate	$2,995.19
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: ECTOPIC PREGNANCY PROCEDURE

Facility

$3,030.43

Service Code	APR-DRG 5452
Min. Negotiated Rate	$3,030.43
Max. Negotiated Rate	$3,030.43
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,030.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,030.43
Rate for Payer: Managed Health Services Medicaid	$3,030.43
Rate for Payer: MDWise Medicaid	$3,030.43

APR-DRG 36.00: EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA

Facility

$10,547.58

Service Code	APR-DRG 9112
Min. Negotiated Rate	$6,977.02
Max. Negotiated Rate	$10,547.58
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,977.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,977.02
Rate for Payer: Managed Health Services Medicaid	$6,977.02
Rate for Payer: MDWise Medicaid	$6,977.02

APR-DRG 36.00: EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA

Facility

$27,968.39

Service Code	APR-DRG 9114
Min. Negotiated Rate	$20,613.94
Max. Negotiated Rate	$27,968.39
Rate for Payer: Anthem Blue Cross of IN Medicaid	$20,613.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$20,613.94
Rate for Payer: Managed Health Services Medicaid	$20,613.94
Rate for Payer: MDWise Medicaid	$20,613.94

APR-DRG 36.00: EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA

Facility

$8,083.60

Service Code	APR-DRG 9111
Min. Negotiated Rate	$6,800.84
Max. Negotiated Rate	$8,083.60
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,800.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,800.84
Rate for Payer: Managed Health Services Medicaid	$6,800.84
Rate for Payer: MDWise Medicaid	$6,800.84

APR-DRG 36.00: EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA

Facility

$16,167.20

Service Code	APR-DRG 9113
Min. Negotiated Rate	$10,289.35
Max. Negotiated Rate	$16,167.20
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,289.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,289.35
Rate for Payer: Managed Health Services Medicaid	$10,289.35
Rate for Payer: MDWise Medicaid	$10,289.35

APR-DRG 36.00: EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$12,233.47

Service Code	APR-DRG 7923
Min. Negotiated Rate	$8,492.24
Max. Negotiated Rate	$12,233.47
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,492.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,492.24
Rate for Payer: Managed Health Services Medicaid	$8,492.24
Rate for Payer: MDWise Medicaid	$8,492.24

APR-DRG 36.00: EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$8,342.97

Service Code	APR-DRG 7922
Min. Negotiated Rate	$6,377.99
Max. Negotiated Rate	$8,342.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,377.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,377.99
Rate for Payer: Managed Health Services Medicaid	$6,377.99
Rate for Payer: MDWise Medicaid	$6,377.99

APR-DRG 36.00: EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$20,749.34

Service Code	APR-DRG 7924
Min. Negotiated Rate	$17,372.09
Max. Negotiated Rate	$20,749.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,372.09
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,372.09
Rate for Payer: Managed Health Services Medicaid	$17,372.09
Rate for Payer: MDWise Medicaid	$17,372.09

APR-DRG 36.00: EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$6,570.63

Service Code	APR-DRG 7921
Min. Negotiated Rate	$4,933.25
Max. Negotiated Rate	$6,570.63
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,933.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,933.25
Rate for Payer: Managed Health Services Medicaid	$4,933.25
Rate for Payer: MDWise Medicaid	$4,933.25

APR-DRG 36.00: EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$23,083.65

Service Code	APR-DRG 9504
Min. Negotiated Rate	$18,605.40
Max. Negotiated Rate	$23,083.65
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,605.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,605.40
Rate for Payer: Managed Health Services Medicaid	$18,605.40
Rate for Payer: MDWise Medicaid	$18,605.40

APR-DRG 36.00: EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$6,873.22

Service Code	APR-DRG 9501
Min. Negotiated Rate	$5,497.05
Max. Negotiated Rate	$6,873.22
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,497.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,497.05
Rate for Payer: Managed Health Services Medicaid	$5,497.05
Rate for Payer: MDWise Medicaid	$5,497.05

Know your out-of-pocket cost for care.

All Charges