Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

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

Facility

$6,138.35

Service Code	APR-DRG 4421
Min. Negotiated Rate	$5,461.81
Max. Negotiated Rate	$6,138.35
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,461.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,461.81
Rate for Payer: Managed Health Services Medicaid	$5,461.81
Rate for Payer: MDWise Medicaid	$5,461.81

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

Facility

$11,066.32

Service Code	APR-DRG 4423
Min. Negotiated Rate	$8,034.15
Max. Negotiated Rate	$11,066.32
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: KIDNEY & URINARY TRACT PROCEDURES FOR NONMALIGNANCY

Facility

$5,835.75

Service Code	APR-DRG 4431
Min. Negotiated Rate	$3,594.22
Max. Negotiated Rate	$5,835.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,594.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,594.22
Rate for Payer: Managed Health Services Medicaid	$3,594.22
Rate for Payer: MDWise Medicaid	$3,594.22

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

Facility

$9,553.34

Service Code	APR-DRG 4433
Min. Negotiated Rate	$6,836.07
Max. Negotiated Rate	$9,553.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,836.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,836.07
Rate for Payer: Managed Health Services Medicaid	$6,836.07
Rate for Payer: MDWise Medicaid	$6,836.07

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

Facility

$15,734.92

Service Code	APR-DRG 4434
Min. Negotiated Rate	$11,346.48
Max. Negotiated Rate	$15,734.92
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,346.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,346.48
Rate for Payer: Managed Health Services Medicaid	$11,346.48
Rate for Payer: MDWise Medicaid	$11,346.48

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

Facility

$7,002.90

Service Code	APR-DRG 4432
Min. Negotiated Rate	$5,250.39
Max. Negotiated Rate	$7,002.90
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: KNEE JOINT REPLACEMENT

Facility

$7,576.06

Service Code	APR-DRG 3022
Min. Negotiated Rate	$7,576.06
Max. Negotiated Rate	$7,576.06
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,576.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,576.06
Rate for Payer: Managed Health Services Medicaid	$7,576.06
Rate for Payer: MDWise Medicaid	$7,576.06

APR-DRG 36.00: KNEE JOINT REPLACEMENT

Facility

$10,712.20

Service Code	APR-DRG 3024
Min. Negotiated Rate	$10,712.20
Max. Negotiated Rate	$10,712.20
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,712.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,712.20
Rate for Payer: Managed Health Services Medicaid	$10,712.20
Rate for Payer: MDWise Medicaid	$10,712.20

APR-DRG 36.00: KNEE JOINT REPLACEMENT

Facility

$7,435.11

Service Code	APR-DRG 3021
Min. Negotiated Rate	$7,435.11
Max. Negotiated Rate	$7,435.11
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,435.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,435.11
Rate for Payer: Managed Health Services Medicaid	$7,435.11
Rate for Payer: MDWise Medicaid	$7,435.11

APR-DRG 36.00: KNEE JOINT REPLACEMENT

Facility

$10,712.20

Service Code	APR-DRG 3023
Min. Negotiated Rate	$10,712.20
Max. Negotiated Rate	$10,712.20
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,712.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,712.20
Rate for Payer: Managed Health Services Medicaid	$10,712.20
Rate for Payer: MDWise Medicaid	$10,712.20

APR-DRG 36.00: KNEE & LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$6,138.35

Service Code	APR-DRG 3131
Min. Negotiated Rate	$5,356.10
Max. Negotiated Rate	$6,138.35
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,356.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,356.10
Rate for Payer: Managed Health Services Medicaid	$5,356.10
Rate for Payer: MDWise Medicaid	$5,356.10

APR-DRG 36.00: KNEE & LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$8,170.05

Service Code	APR-DRG 3132
Min. Negotiated Rate	$7,153.21
Max. Negotiated Rate	$8,170.05
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,153.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,153.21
Rate for Payer: Managed Health Services Medicaid	$7,153.21
Rate for Payer: MDWise Medicaid	$7,153.21

APR-DRG 36.00: KNEE & LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$11,585.05

Service Code	APR-DRG 3133
Min. Negotiated Rate	$10,395.06
Max. Negotiated Rate	$11,585.05
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,395.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,395.06
Rate for Payer: Managed Health Services Medicaid	$10,395.06
Rate for Payer: MDWise Medicaid	$10,395.06

APR-DRG 36.00: KNEE & LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$17,161.44

Service Code	APR-DRG 3134
Min. Negotiated Rate	$13,319.77
Max. Negotiated Rate	$17,161.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,319.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,319.77
Rate for Payer: Managed Health Services Medicaid	$13,319.77
Rate for Payer: MDWise Medicaid	$13,319.77

APR-DRG 36.00: LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT

Facility

$26,801.24

Service Code	APR-DRG 0011
Min. Negotiated Rate	$23,115.80
Max. Negotiated Rate	$26,801.24
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,115.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,115.80
Rate for Payer: Managed Health Services Medicaid	$23,115.80
Rate for Payer: MDWise Medicaid	$23,115.80

APR-DRG 36.00: LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT

Facility

$76,080.93

Service Code	APR-DRG 0014
Min. Negotiated Rate	$71,990.21
Max. Negotiated Rate	$76,080.93
Rate for Payer: Anthem Blue Cross of IN Medicaid	$71,990.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$71,990.21
Rate for Payer: Managed Health Services Medicaid	$71,990.21
Rate for Payer: MDWise Medicaid	$71,990.21

APR-DRG 36.00: LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT

Facility

$30,518.83

Service Code	APR-DRG 0012
Min. Negotiated Rate	$23,115.80
Max. Negotiated Rate	$30,518.83
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,115.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,115.80
Rate for Payer: Managed Health Services Medicaid	$23,115.80
Rate for Payer: MDWise Medicaid	$23,115.80

APR-DRG 36.00: LIVER TRANSPLANT &/OR INTESTINAL TRANSPLANT

Facility

$39,510.21

Service Code	APR-DRG 0013
Min. Negotiated Rate	$23,115.80
Max. Negotiated Rate	$39,510.21
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,115.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,115.80
Rate for Payer: Managed Health Services Medicaid	$23,115.80
Rate for Payer: MDWise Medicaid	$23,115.80

APR-DRG 36.00: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$21,389.16

Service Code	APR-DRG 1814
Min. Negotiated Rate	$20,230.61
Max. Negotiated Rate	$21,389.16
Rate for Payer: Anthem Blue Cross of IN Medicaid	$21,389.16
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$21,389.16
Rate for Payer: Managed Health Services Medicaid	$21,389.16
Rate for Payer: MDWise Medicaid	$21,389.16

APR-DRG 36.00: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$7,564.86

Service Code	APR-DRG 1811
Min. Negotiated Rate	$6,730.36
Max. Negotiated Rate	$7,564.86
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,730.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,730.36
Rate for Payer: Managed Health Services Medicaid	$6,730.36
Rate for Payer: MDWise Medicaid	$6,730.36

APR-DRG 36.00: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$10,417.90

Service Code	APR-DRG 1812
Min. Negotiated Rate	$8,915.09
Max. Negotiated Rate	$10,417.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,915.09
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,915.09
Rate for Payer: Managed Health Services Medicaid	$8,915.09
Rate for Payer: MDWise Medicaid	$8,915.09

APR-DRG 36.00: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$14,165.48

Service Code	APR-DRG 1813
Min. Negotiated Rate	$13,919.35
Max. Negotiated Rate	$14,165.48
Rate for Payer: Anthem Blue Cross of IN Medicaid	$14,165.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$14,165.48
Rate for Payer: Managed Health Services Medicaid	$14,165.48
Rate for Payer: MDWise Medicaid	$14,165.48

APR-DRG 36.00: LYMPHATIC & OTHER MALIGNANCIES & NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$10,288.22

Service Code	APR-DRG 6944
Min. Negotiated Rate	$7,012.26
Max. Negotiated Rate	$10,288.22
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,012.26
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,012.26
Rate for Payer: Managed Health Services Medicaid	$7,012.26
Rate for Payer: MDWise Medicaid	$7,012.26

APR-DRG 36.00: LYMPHATIC & OTHER MALIGNANCIES & NEOPLASMS OF UNCERTAIN BEHAVIOR

Facility

$4,122.79

Service Code	APR-DRG 6942
Min. Negotiated Rate	$4,106.64
Max. Negotiated Rate	$4,122.79
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,122.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,122.79
Rate for Payer: Managed Health Services Medicaid	$4,122.79
Rate for Payer: MDWise Medicaid	$4,122.79

Know your out-of-pocket cost for care.

All Charges