Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: HIP JOINT REPLACEMENT

Facility

$8,421.76

Service Code	APR-DRG 3012
Min. Negotiated Rate	$8,421.76
Max. Negotiated Rate	$8,421.76
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,421.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,421.76
Rate for Payer: Managed Health Services Medicaid	$8,421.76
Rate for Payer: MDWise Medicaid	$8,421.76

APR-DRG 36.00: HIP JOINT REPLACEMENT

Facility

$7,752.25

Service Code	APR-DRG 3011
Min. Negotiated Rate	$7,752.25
Max. Negotiated Rate	$7,752.25
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,752.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,752.25
Rate for Payer: Managed Health Services Medicaid	$7,752.25
Rate for Payer: MDWise Medicaid	$7,752.25

APR-DRG 36.00: HIV W MAJOR HIV RELATED CONDITION

Facility

$4,149.87

Service Code	APR-DRG 8922
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$4,149.87
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: HIV W MAJOR HIV RELATED CONDITION

Facility

$9,726.25

Service Code	APR-DRG 8924
Min. Negotiated Rate	$7,329.40
Max. Negotiated Rate	$9,726.25
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,329.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,329.40
Rate for Payer: Managed Health Services Medicaid	$7,329.40
Rate for Payer: MDWise Medicaid	$7,329.40

APR-DRG 36.00: HIV W MAJOR HIV RELATED CONDITION

Facility

$3,371.77

Service Code	APR-DRG 8921
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$3,371.77
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: HIV W MAJOR HIV RELATED CONDITION

Facility

$5,922.21

Service Code	APR-DRG 8923
Min. Negotiated Rate	$3,418.04
Max. Negotiated Rate	$5,922.21
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,418.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,418.04
Rate for Payer: Managed Health Services Medicaid	$3,418.04
Rate for Payer: MDWise Medicaid	$3,418.04

APR-DRG 36.00: HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$14,783.91

Service Code	APR-DRG 8904
Min. Negotiated Rate	$11,452.19
Max. Negotiated Rate	$14,783.91
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,452.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,452.19
Rate for Payer: Managed Health Services Medicaid	$11,452.19
Rate for Payer: MDWise Medicaid	$11,452.19

APR-DRG 36.00: HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$4,798.29

Service Code	APR-DRG 8902
Min. Negotiated Rate	$4,439.93
Max. Negotiated Rate	$4,798.29
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: HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$4,439.93

Service Code	APR-DRG 8901
Min. Negotiated Rate	$3,415.00
Max. Negotiated Rate	$4,439.93
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: HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$8,299.74

Service Code	APR-DRG 8903
Min. Negotiated Rate	$4,439.93
Max. Negotiated Rate	$8,299.74
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: HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility

$9,293.98

Service Code	APR-DRG 8934
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$9,293.98
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: HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility

$5,446.70

Service Code	APR-DRG 8933
Min. Negotiated Rate	$2,572.34
Max. Negotiated Rate	$5,446.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,572.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,572.34
Rate for Payer: Managed Health Services Medicaid	$2,572.34
Rate for Payer: MDWise Medicaid	$2,572.34

APR-DRG 36.00: HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility

$3,155.63

Service Code	APR-DRG 8931
Min. Negotiated Rate	$2,572.34
Max. Negotiated Rate	$3,155.63
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,572.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,572.34
Rate for Payer: Managed Health Services Medicaid	$2,572.34
Rate for Payer: MDWise Medicaid	$2,572.34

APR-DRG 36.00: HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility

$4,495.69

Service Code	APR-DRG 8932
Min. Negotiated Rate	$2,572.34
Max. Negotiated Rate	$4,495.69
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,572.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,572.34
Rate for Payer: Managed Health Services Medicaid	$2,572.34
Rate for Payer: MDWise Medicaid	$2,572.34

APR-DRG 36.00: HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND

Facility

$4,841.51

Service Code	APR-DRG 8943
Min. Negotiated Rate	$2,748.53
Max. Negotiated Rate	$4,841.51
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: HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND

Facility

$2,896.26

Service Code	APR-DRG 8941
Min. Negotiated Rate	$2,748.53
Max. Negotiated Rate	$2,896.26
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: HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND

Facility

$3,674.36

Service Code	APR-DRG 8942
Min. Negotiated Rate	$2,748.53
Max. Negotiated Rate	$3,674.36
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: HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND

Facility

$8,040.37

Service Code	APR-DRG 8944
Min. Negotiated Rate	$4,017.07
Max. Negotiated Rate	$8,040.37
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,017.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,017.07
Rate for Payer: Managed Health Services Medicaid	$4,017.07
Rate for Payer: MDWise Medicaid	$4,017.07

APR-DRG 36.00: HYPERTENSION

Facility

$2,982.72

Service Code	APR-DRG 1992
Min. Negotiated Rate	$2,607.57
Max. Negotiated Rate	$2,982.72
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: HYPERTENSION

Facility

$2,550.44

Service Code	APR-DRG 1991
Min. Negotiated Rate	$2,079.01
Max. Negotiated Rate	$2,550.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,079.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,079.01
Rate for Payer: Managed Health Services Medicaid	$2,079.01
Rate for Payer: MDWise Medicaid	$2,079.01

APR-DRG 36.00: HYPERTENSION

Facility

$8,429.42

Service Code	APR-DRG 1994
Min. Negotiated Rate	$4,616.11
Max. Negotiated Rate	$8,429.42
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,616.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,616.11
Rate for Payer: Managed Health Services Medicaid	$4,616.11
Rate for Payer: MDWise Medicaid	$4,616.11

APR-DRG 36.00: HYPERTENSION

Facility

$4,495.69

Service Code	APR-DRG 1993
Min. Negotiated Rate	$3,911.36
Max. Negotiated Rate	$4,495.69
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,911.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,911.36
Rate for Payer: Managed Health Services Medicaid	$3,911.36
Rate for Payer: MDWise Medicaid	$3,911.36

APR-DRG 36.00: HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS

Facility

$6,051.89

Service Code	APR-DRG 4224
Min. Negotiated Rate	$4,439.93
Max. Negotiated Rate	$6,051.89
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: HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS

Facility

$3,717.59

Service Code	APR-DRG 4223
Min. Negotiated Rate	$3,418.04
Max. Negotiated Rate	$3,717.59
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,418.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,418.04
Rate for Payer: Managed Health Services Medicaid	$3,418.04
Rate for Payer: MDWise Medicaid	$3,418.04

APR-DRG 36.00: HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS

Facility

$2,550.44

Service Code	APR-DRG 4222
Min. Negotiated Rate	$2,079.01
Max. Negotiated Rate	$2,550.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,079.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,079.01
Rate for Payer: Managed Health Services Medicaid	$2,079.01
Rate for Payer: MDWise Medicaid	$2,079.01

Know your out-of-pocket cost for care.

All Charges