Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

$13,876.12

Service Code	APR-DRG 9503
Min. Negotiated Rate	$8,527.48
Max. Negotiated Rate	$13,876.12
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,527.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,527.48
Rate for Payer: Managed Health Services Medicaid	$8,527.48
Rate for Payer: MDWise Medicaid	$8,527.48

APR-DRG 36.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$99,985.90

Service Code	APR-DRG 0094
Min. Negotiated Rate	$65,013.19
Max. Negotiated Rate	$99,985.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$65,013.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$65,013.19
Rate for Payer: Managed Health Services Medicaid	$65,013.19
Rate for Payer: MDWise Medicaid	$65,013.19

APR-DRG 36.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$67,219.23

Service Code	APR-DRG 0093
Min. Negotiated Rate	$37,527.94
Max. Negotiated Rate	$67,219.23
Rate for Payer: Anthem Blue Cross of IN Medicaid	$37,527.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$37,527.94
Rate for Payer: Managed Health Services Medicaid	$37,527.94
Rate for Payer: MDWise Medicaid	$37,527.94

APR-DRG 36.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$37,527.94

Service Code	APR-DRG 0092
Min. Negotiated Rate	$33,717.68
Max. Negotiated Rate	$37,527.94
Rate for Payer: Anthem Blue Cross of IN Medicaid	$37,527.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$37,527.94
Rate for Payer: Managed Health Services Medicaid	$37,527.94
Rate for Payer: MDWise Medicaid	$37,527.94

APR-DRG 36.00: EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$37,527.94

Service Code	APR-DRG 0091
Min. Negotiated Rate	$24,683.07
Max. Negotiated Rate	$37,527.94
Rate for Payer: Anthem Blue Cross of IN Medicaid	$37,527.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$37,527.94
Rate for Payer: Managed Health Services Medicaid	$37,527.94
Rate for Payer: MDWise Medicaid	$37,527.94

APR-DRG 36.00: EXTRACRANIAL VASCULAR PROCEDURES

Facility

$16,632.10

Service Code	APR-DRG 0244
Min. Negotiated Rate	$16,123.97
Max. Negotiated Rate	$16,632.10
Rate for Payer: Anthem Blue Cross of IN Medicaid	$16,632.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$16,632.10
Rate for Payer: Managed Health Services Medicaid	$16,632.10
Rate for Payer: MDWise Medicaid	$16,632.10

APR-DRG 36.00: EXTRACRANIAL VASCULAR PROCEDURES

Facility

$5,497.05

Service Code	APR-DRG 0241
Min. Negotiated Rate	$4,366.01
Max. Negotiated Rate	$5,497.05
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

APR-DRG 36.00: EXTRACRANIAL VASCULAR PROCEDURES

Facility

$10,331.44

Service Code	APR-DRG 0243
Min. Negotiated Rate	$9,619.84
Max. Negotiated Rate	$10,331.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,619.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,619.84
Rate for Payer: Managed Health Services Medicaid	$9,619.84
Rate for Payer: MDWise Medicaid	$9,619.84

APR-DRG 36.00: EXTRACRANIAL VASCULAR PROCEDURES

Facility

$8,034.15

Service Code	APR-DRG 0242
Min. Negotiated Rate	$5,792.53
Max. Negotiated Rate	$8,034.15
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,034.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,034.15
Rate for Payer: Managed Health Services Medicaid	$8,034.15
Rate for Payer: MDWise Medicaid	$8,034.15

APR-DRG 36.00: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$2,723.35

Service Code	APR-DRG 0821
Min. Negotiated Rate	$2,149.49
Max. Negotiated Rate	$2,723.35
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,149.49
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,149.49
Rate for Payer: Managed Health Services Medicaid	$2,149.49
Rate for Payer: MDWise Medicaid	$2,149.49

APR-DRG 36.00: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$3,501.45

Service Code	APR-DRG 0822
Min. Negotiated Rate	$2,607.57
Max. Negotiated Rate	$3,501.45
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: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$8,861.70

Service Code	APR-DRG 0824
Min. Negotiated Rate	$4,228.50
Max. Negotiated Rate	$8,861.70
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: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$5,187.34

Service Code	APR-DRG 0823
Min. Negotiated Rate	$3,171.38
Max. Negotiated Rate	$5,187.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,171.38
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,171.38
Rate for Payer: Managed Health Services Medicaid	$3,171.38
Rate for Payer: MDWise Medicaid	$3,171.38

APR-DRG 36.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility

$22,132.63

Service Code	APR-DRG 0924
Min. Negotiated Rate	$17,900.65
Max. Negotiated Rate	$22,132.63
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,900.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,900.65
Rate for Payer: Managed Health Services Medicaid	$17,900.65
Rate for Payer: MDWise Medicaid	$17,900.65

APR-DRG 36.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility

$12,579.29

Service Code	APR-DRG 0923
Min. Negotiated Rate	$9,443.65
Max. Negotiated Rate	$12,579.29
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,443.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,443.65
Rate for Payer: Managed Health Services Medicaid	$9,443.65
Rate for Payer: MDWise Medicaid	$9,443.65

APR-DRG 36.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility

$8,559.10

Service Code	APR-DRG 0922
Min. Negotiated Rate	$5,426.57
Max. Negotiated Rate	$8,559.10
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,426.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,426.57
Rate for Payer: Managed Health Services Medicaid	$5,426.57
Rate for Payer: MDWise Medicaid	$5,426.57

APR-DRG 36.00: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility

$6,829.99

Service Code	APR-DRG 0921
Min. Negotiated Rate	$5,426.57
Max. Negotiated Rate	$6,829.99
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,426.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,426.57
Rate for Payer: Managed Health Services Medicaid	$5,426.57
Rate for Payer: MDWise Medicaid	$5,426.57

APR-DRG 36.00: FALSE LABOR

Facility

$2,043.78

Service Code	APR-DRG 5652
Min. Negotiated Rate	$2,043.78
Max. Negotiated Rate	$2,043.78
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,043.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,043.78
Rate for Payer: Managed Health Services Medicaid	$2,043.78
Rate for Payer: MDWise Medicaid	$2,043.78

APR-DRG 36.00: FALSE LABOR

Facility

$2,043.78

Service Code	APR-DRG 5653
Min. Negotiated Rate	$2,043.78
Max. Negotiated Rate	$2,043.78
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,043.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,043.78
Rate for Payer: Managed Health Services Medicaid	$2,043.78
Rate for Payer: MDWise Medicaid	$2,043.78

APR-DRG 36.00: FALSE LABOR

Facility

$528.56

Service Code	APR-DRG 5651
Min. Negotiated Rate	$528.56
Max. Negotiated Rate	$528.56
Rate for Payer: Anthem Blue Cross of IN Medicaid	$528.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$528.56
Rate for Payer: Managed Health Services Medicaid	$528.56
Rate for Payer: MDWise Medicaid	$528.56

APR-DRG 36.00: FALSE LABOR

Facility

$2,043.78

Service Code	APR-DRG 5654
Min. Negotiated Rate	$2,043.78
Max. Negotiated Rate	$2,043.78
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,043.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,043.78
Rate for Payer: Managed Health Services Medicaid	$2,043.78
Rate for Payer: MDWise Medicaid	$2,043.78

APR-DRG 36.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$9,466.89

Service Code	APR-DRG 5314
Min. Negotiated Rate	$3,629.46
Max. Negotiated Rate	$9,466.89
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,629.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,629.46
Rate for Payer: Managed Health Services Medicaid	$3,629.46
Rate for Payer: MDWise Medicaid	$3,629.46

APR-DRG 36.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$3,025.95

Service Code	APR-DRG 5312
Min. Negotiated Rate	$2,537.10
Max. Negotiated Rate	$3,025.95
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,537.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,537.10
Rate for Payer: Managed Health Services Medicaid	$2,537.10
Rate for Payer: MDWise Medicaid	$2,537.10

APR-DRG 36.00: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$5,100.88

Service Code	APR-DRG 5313
Min. Negotiated Rate	$2,889.47
Max. Negotiated Rate	$5,100.88
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

Know your out-of-pocket cost for care.

All Charges