Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK

Facility

$4,841.51

Service Code	APR-DRG 3423
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$4,841.51
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: FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK

Facility

$4,263.74

Service Code	APR-DRG 3421
Min. Negotiated Rate	$2,636.90
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: FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK

Facility

$4,263.74

Service Code	APR-DRG 3422
Min. Negotiated Rate	$3,415.00
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: FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK

Facility

$8,818.47

Service Code	APR-DRG 3424
Min. Negotiated Rate	$5,250.39
Max. Negotiated Rate	$8,818.47
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,250.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,250.39
Rate for Payer: Managed Health Services Medicaid	$5,250.39
Rate for Payer: MDWise Medicaid	$5,250.39

APR-DRG 36.00: GASTRIC FUNDOPLICATION

Facility

$5,273.79

Service Code	APR-DRG 2321
Min. Negotiated Rate	$3,876.12
Max. Negotiated Rate	$5,273.79
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,876.12
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,876.12
Rate for Payer: Managed Health Services Medicaid	$3,876.12
Rate for Payer: MDWise Medicaid	$3,876.12

APR-DRG 36.00: GASTRIC FUNDOPLICATION

Facility

$6,570.63

Service Code	APR-DRG 2322
Min. Negotiated Rate	$4,757.06
Max. Negotiated Rate	$6,570.63
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,757.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,757.06
Rate for Payer: Managed Health Services Medicaid	$4,757.06
Rate for Payer: MDWise Medicaid	$4,757.06

APR-DRG 36.00: GASTRIC FUNDOPLICATION

Facility

$10,461.13

Service Code	APR-DRG 2323
Min. Negotiated Rate	$5,144.68
Max. Negotiated Rate	$10,461.13
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: GASTRIC FUNDOPLICATION

Facility

$16,772.39

Service Code	APR-DRG 2324
Min. Negotiated Rate	$10,500.77
Max. Negotiated Rate	$16,772.39
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,500.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,500.77
Rate for Payer: Managed Health Services Medicaid	$10,500.77
Rate for Payer: MDWise Medicaid	$10,500.77

APR-DRG 36.00: GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$2,680.12

Service Code	APR-DRG 2461
Min. Negotiated Rate	$2,396.15
Max. Negotiated Rate	$2,680.12
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,396.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,396.15
Rate for Payer: Managed Health Services Medicaid	$2,396.15
Rate for Payer: MDWise Medicaid	$2,396.15

APR-DRG 36.00: GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$3,415.00

Service Code	APR-DRG 2462
Min. Negotiated Rate	$3,030.43
Max. Negotiated Rate	$3,415.00
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: GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$8,342.97

Service Code	APR-DRG 2464
Min. Negotiated Rate	$6,659.89
Max. Negotiated Rate	$8,342.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,659.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,659.89
Rate for Payer: Managed Health Services Medicaid	$6,659.89
Rate for Payer: MDWise Medicaid	$6,659.89

APR-DRG 36.00: GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$5,187.34

Service Code	APR-DRG 2463
Min. Negotiated Rate	$3,347.56
Max. Negotiated Rate	$5,187.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,347.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,347.56
Rate for Payer: Managed Health Services Medicaid	$3,347.56
Rate for Payer: MDWise Medicaid	$3,347.56

APR-DRG 36.00: HAND & WRIST PROCEDURES

Facility

$13,659.98

Service Code	APR-DRG 3164
Min. Negotiated Rate	$9,302.70
Max. Negotiated Rate	$13,659.98
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,302.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,302.70
Rate for Payer: Managed Health Services Medicaid	$9,302.70
Rate for Payer: MDWise Medicaid	$9,302.70

APR-DRG 36.00: HAND & WRIST PROCEDURES

Facility

$4,279.55

Service Code	APR-DRG 3161
Min. Negotiated Rate	$2,959.95
Max. Negotiated Rate	$4,279.55
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: HAND & WRIST PROCEDURES

Facility

$5,749.30

Service Code	APR-DRG 3162
Min. Negotiated Rate	$4,193.26
Max. Negotiated Rate	$5,749.30
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,193.26
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,193.26
Rate for Payer: Managed Health Services Medicaid	$4,193.26
Rate for Payer: MDWise Medicaid	$4,193.26

APR-DRG 36.00: HAND & WRIST PROCEDURES

Facility

$8,602.33

Service Code	APR-DRG 3163
Min. Negotiated Rate	$5,532.29
Max. Negotiated Rate	$8,602.33
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,532.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,532.29
Rate for Payer: Managed Health Services Medicaid	$5,532.29
Rate for Payer: MDWise Medicaid	$5,532.29

APR-DRG 36.00: HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE

Facility

$11,974.10

Service Code	APR-DRG 0554
Min. Negotiated Rate	$10,536.01
Max. Negotiated Rate	$11,974.10
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,536.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,536.01
Rate for Payer: Managed Health Services Medicaid	$10,536.01
Rate for Payer: MDWise Medicaid	$10,536.01

APR-DRG 36.00: HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE

Facility

$3,198.86

Service Code	APR-DRG 0551
Min. Negotiated Rate	$2,149.49
Max. Negotiated Rate	$3,198.86
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: HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE

Facility

$4,452.46

Service Code	APR-DRG 0552
Min. Negotiated Rate	$3,699.94
Max. Negotiated Rate	$4,452.46
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,699.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,699.94
Rate for Payer: Managed Health Services Medicaid	$3,699.94
Rate for Payer: MDWise Medicaid	$3,699.94

APR-DRG 36.00: HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE

Facility

$6,916.45

Service Code	APR-DRG 0553
Min. Negotiated Rate	$5,567.52
Max. Negotiated Rate	$6,916.45
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,567.52
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,567.52
Rate for Payer: Managed Health Services Medicaid	$5,567.52
Rate for Payer: MDWise Medicaid	$5,567.52

APR-DRG 36.00: HEAD TRAUMA WITH DEEP COMA

Facility

$27,273.83

Service Code	APR-DRG 0102
Min. Negotiated Rate	$27,273.83
Max. Negotiated Rate	$27,273.83
Rate for Payer: Anthem Blue Cross of IN Medicaid	$27,273.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$27,273.83
Rate for Payer: Managed Health Services Medicaid	$27,273.83
Rate for Payer: MDWise Medicaid	$27,273.83

APR-DRG 36.00: HEAD TRAUMA WITH DEEP COMA

Facility

$27,273.83

Service Code	APR-DRG 0101
Min. Negotiated Rate	$27,273.83
Max. Negotiated Rate	$27,273.83
Rate for Payer: Anthem Blue Cross of IN Medicaid	$27,273.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$27,273.83
Rate for Payer: Managed Health Services Medicaid	$27,273.83
Rate for Payer: MDWise Medicaid	$27,273.83

APR-DRG 36.00: HEAD TRAUMA WITH DEEP COMA

Facility

$29,352.84

Service Code	APR-DRG 0104
Min. Negotiated Rate	$29,352.84
Max. Negotiated Rate	$29,352.84
Rate for Payer: Anthem Blue Cross of IN Medicaid	$29,352.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$29,352.84
Rate for Payer: Managed Health Services Medicaid	$29,352.84
Rate for Payer: MDWise Medicaid	$29,352.84

APR-DRG 36.00: HEAD TRAUMA WITH DEEP COMA

Facility

$27,273.83

Service Code	APR-DRG 0103
Min. Negotiated Rate	$27,273.83
Max. Negotiated Rate	$27,273.83
Rate for Payer: Anthem Blue Cross of IN Medicaid	$27,273.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$27,273.83
Rate for Payer: Managed Health Services Medicaid	$27,273.83
Rate for Payer: MDWise Medicaid	$27,273.83

APR-DRG 36.00: HEART FAILURE

Facility

$3,198.86

Service Code	APR-DRG 1942
Min. Negotiated Rate	$2,924.71
Max. Negotiated Rate	$3,198.86
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,924.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,924.71
Rate for Payer: Managed Health Services Medicaid	$2,924.71
Rate for Payer: MDWise Medicaid	$2,924.71

Know your out-of-pocket cost for care.

All Charges