Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: INTERVERTEBRAL DISC EXCISION & DECOMPRESSION

Facility

$7,608.09

Service Code	APR-DRG 3102
Min. Negotiated Rate	$4,439.93
Max. Negotiated Rate	$7,608.09
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: INTERVERTEBRAL DISC EXCISION & DECOMPRESSION

Facility

$15,951.06

Service Code	APR-DRG 3104
Min. Negotiated Rate	$9,549.36
Max. Negotiated Rate	$15,951.06
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,549.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,549.36
Rate for Payer: Managed Health Services Medicaid	$9,549.36
Rate for Payer: MDWise Medicaid	$9,549.36

APR-DRG 36.00: INTERVERTEBRAL DISC EXCISION & DECOMPRESSION

Facility

$5,533.16

Service Code	APR-DRG 3101
Min. Negotiated Rate	$3,100.90
Max. Negotiated Rate	$5,533.16
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,100.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,100.90
Rate for Payer: Managed Health Services Medicaid	$3,100.90
Rate for Payer: MDWise Medicaid	$3,100.90

APR-DRG 36.00: INTERVERTEBRAL DISC EXCISION & DECOMPRESSION

Facility

$10,936.63

Service Code	APR-DRG 3103
Min. Negotiated Rate	$6,272.27
Max. Negotiated Rate	$10,936.63
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,272.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,272.27
Rate for Payer: Managed Health Services Medicaid	$6,272.27
Rate for Payer: MDWise Medicaid	$6,272.27

APR-DRG 36.00: INTESTINAL OBSTRUCTION

Facility

$8,083.60

Service Code	APR-DRG 2474
Min. Negotiated Rate	$5,320.86
Max. Negotiated Rate	$8,083.60
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,320.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,320.86
Rate for Payer: Managed Health Services Medicaid	$5,320.86
Rate for Payer: MDWise Medicaid	$5,320.86

APR-DRG 36.00: INTESTINAL OBSTRUCTION

Facility

$4,495.69

Service Code	APR-DRG 2473
Min. Negotiated Rate	$4,369.45
Max. Negotiated Rate	$4,495.69
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,369.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,369.45
Rate for Payer: Managed Health Services Medicaid	$4,369.45
Rate for Payer: MDWise Medicaid	$4,369.45

APR-DRG 36.00: INTESTINAL OBSTRUCTION

Facility

$3,100.90

Service Code	APR-DRG 2472
Min. Negotiated Rate	$2,809.81
Max. Negotiated Rate	$3,100.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,100.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,100.90
Rate for Payer: Managed Health Services Medicaid	$3,100.90
Rate for Payer: MDWise Medicaid	$3,100.90

APR-DRG 36.00: INTESTINAL OBSTRUCTION

Facility

$2,290.44

Service Code	APR-DRG 2471
Min. Negotiated Rate	$2,118.16
Max. Negotiated Rate	$2,290.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,290.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,290.44
Rate for Payer: Managed Health Services Medicaid	$2,290.44
Rate for Payer: MDWise Medicaid	$2,290.44

APR-DRG 36.00: INTRACRANIAL HEMORRHAGE

Facility

$6,916.45

Service Code	APR-DRG 0443
Min. Negotiated Rate	$4,933.25
Max. Negotiated Rate	$6,916.45
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: INTRACRANIAL HEMORRHAGE

Facility

$3,760.82

Service Code	APR-DRG 0441
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$3,760.82
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: INTRACRANIAL HEMORRHAGE

Facility

$10,634.04

Service Code	APR-DRG 0444
Min. Negotiated Rate	$6,166.56
Max. Negotiated Rate	$10,634.04
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,166.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,166.56
Rate for Payer: Managed Health Services Medicaid	$6,166.56
Rate for Payer: MDWise Medicaid	$6,166.56

APR-DRG 36.00: INTRACRANIAL HEMORRHAGE

Facility

$4,884.74

Service Code	APR-DRG 0442
Min. Negotiated Rate	$3,629.46
Max. Negotiated Rate	$4,884.74
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: KIDNEY TRANSPLANT

Facility

$26,196.05

Service Code	APR-DRG 4403
Min. Negotiated Rate	$21,494.88
Max. Negotiated Rate	$26,196.05
Rate for Payer: Anthem Blue Cross of IN Medicaid	$21,494.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$21,494.88
Rate for Payer: Managed Health Services Medicaid	$21,494.88
Rate for Payer: MDWise Medicaid	$21,494.88

APR-DRG 36.00: KIDNEY TRANSPLANT

Facility

$20,879.03

Service Code	APR-DRG 4401
Min. Negotiated Rate	$18,182.55
Max. Negotiated Rate	$20,879.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,182.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,182.55
Rate for Payer: Managed Health Services Medicaid	$18,182.55
Rate for Payer: MDWise Medicaid	$18,182.55

APR-DRG 36.00: KIDNEY TRANSPLANT

Facility

$22,305.54

Service Code	APR-DRG 4402
Min. Negotiated Rate	$18,640.64
Max. Negotiated Rate	$22,305.54
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,640.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,640.64
Rate for Payer: Managed Health Services Medicaid	$18,640.64
Rate for Payer: MDWise Medicaid	$18,640.64

APR-DRG 36.00: KIDNEY TRANSPLANT

Facility

$38,515.97

Service Code	APR-DRG 4404
Min. Negotiated Rate	$36,506.05
Max. Negotiated Rate	$38,515.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$36,506.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$36,506.05
Rate for Payer: Managed Health Services Medicaid	$36,506.05
Rate for Payer: MDWise Medicaid	$36,506.05

APR-DRG 36.00: KIDNEY & URINARY TRACT INFECTIONS

Facility

$2,247.85

Service Code	APR-DRG 4631
Min. Negotiated Rate	$1,867.59
Max. Negotiated Rate	$2,247.85
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,867.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,867.59
Rate for Payer: Managed Health Services Medicaid	$1,867.59
Rate for Payer: MDWise Medicaid	$1,867.59

APR-DRG 36.00: KIDNEY & URINARY TRACT INFECTIONS

Facility

$2,853.03

Service Code	APR-DRG 4632
Min. Negotiated Rate	$2,255.20
Max. Negotiated Rate	$2,853.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,255.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,255.20
Rate for Payer: Managed Health Services Medicaid	$2,255.20
Rate for Payer: MDWise Medicaid	$2,255.20

APR-DRG 36.00: KIDNEY & URINARY TRACT INFECTIONS

Facility

$3,933.73

Service Code	APR-DRG 4633
Min. Negotiated Rate	$3,382.80
Max. Negotiated Rate	$3,933.73
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,382.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,382.80
Rate for Payer: Managed Health Services Medicaid	$3,382.80
Rate for Payer: MDWise Medicaid	$3,382.80

APR-DRG 36.00: KIDNEY & URINARY TRACT INFECTIONS

Facility

$6,527.40

Service Code	APR-DRG 4634
Min. Negotiated Rate	$3,946.60
Max. Negotiated Rate	$6,527.40
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,946.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,946.60
Rate for Payer: Managed Health Services Medicaid	$3,946.60
Rate for Payer: MDWise Medicaid	$3,946.60

APR-DRG 36.00: KIDNEY & URINARY TRACT MALIGNANCY

Facility

$10,244.99

Service Code	APR-DRG 4614
Min. Negotiated Rate	$5,215.15
Max. Negotiated Rate	$10,244.99
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,215.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,215.15
Rate for Payer: Managed Health Services Medicaid	$5,215.15
Rate for Payer: MDWise Medicaid	$5,215.15

APR-DRG 36.00: KIDNEY & URINARY TRACT MALIGNANCY

Facility

$5,965.44

Service Code	APR-DRG 4613
Min. Negotiated Rate	$3,382.80
Max. Negotiated Rate	$5,965.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,382.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,382.80
Rate for Payer: Managed Health Services Medicaid	$3,382.80
Rate for Payer: MDWise Medicaid	$3,382.80

APR-DRG 36.00: KIDNEY & URINARY TRACT MALIGNANCY

Facility

$3,382.80

Service Code	APR-DRG 4611
Min. Negotiated Rate	$3,285.31
Max. Negotiated Rate	$3,382.80
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,382.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,382.80
Rate for Payer: Managed Health Services Medicaid	$3,382.80
Rate for Payer: MDWise Medicaid	$3,382.80

APR-DRG 36.00: KIDNEY & URINARY TRACT MALIGNANCY

Facility

$3,933.73

Service Code	APR-DRG 4612
Min. Negotiated Rate	$3,382.80
Max. Negotiated Rate	$3,933.73
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,382.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,382.80
Rate for Payer: Managed Health Services Medicaid	$3,382.80
Rate for Payer: MDWise Medicaid	$3,382.80

APR-DRG 36.00: KIDNEY & URINARY TRACT PROCEDURES FOR MALIGNANCY

Facility

$18,415.04

Service Code	APR-DRG 4424
Min. Negotiated Rate	$13,777.86
Max. Negotiated Rate	$18,415.04
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,777.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,777.86
Rate for Payer: Managed Health Services Medicaid	$13,777.86
Rate for Payer: MDWise Medicaid	$13,777.86

Know your out-of-pocket cost for care.

All Charges