Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$14,049.03

Service Code	APR-DRG 2203
Min. Negotiated Rate	$13,883.58
Max. Negotiated Rate	$14,049.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,883.58
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,883.58
Rate for Payer: Managed Health Services Medicaid	$13,883.58
Rate for Payer: MDWise Medicaid	$13,883.58

APR-DRG 36.00: MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$9,596.57

Service Code	APR-DRG 2202
Min. Negotiated Rate	$7,470.35
Max. Negotiated Rate	$9,596.57
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,470.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,470.35
Rate for Payer: Managed Health Services Medicaid	$7,470.35
Rate for Payer: MDWise Medicaid	$7,470.35

APR-DRG 36.00: MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$6,657.08

Service Code	APR-DRG 2201
Min. Negotiated Rate	$5,814.19
Max. Negotiated Rate	$6,657.08
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,814.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,814.19
Rate for Payer: Managed Health Services Medicaid	$5,814.19
Rate for Payer: MDWise Medicaid	$5,814.19

APR-DRG 36.00: MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$2,377.53

Service Code	APR-DRG 5011
Min. Negotiated Rate	$2,255.20
Max. Negotiated Rate	$2,377.53
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: MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$3,025.95

Service Code	APR-DRG 5012
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$3,025.95
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: MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$4,495.69

Service Code	APR-DRG 5013
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$4,495.69
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: MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$9,250.75

Service Code	APR-DRG 5014
Min. Negotiated Rate	$5,849.43
Max. Negotiated Rate	$9,250.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,849.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,849.43
Rate for Payer: Managed Health Services Medicaid	$5,849.43
Rate for Payer: MDWise Medicaid	$5,849.43

APR-DRG 36.00: MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility

$5,792.53

Service Code	APR-DRG 2063
Min. Negotiated Rate	$4,158.02
Max. Negotiated Rate	$5,792.53
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,158.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,158.02
Rate for Payer: Managed Health Services Medicaid	$4,158.02
Rate for Payer: MDWise Medicaid	$4,158.02

APR-DRG 36.00: MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility

$10,115.31

Service Code	APR-DRG 2064
Min. Negotiated Rate	$6,800.84
Max. Negotiated Rate	$10,115.31
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,800.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,800.84
Rate for Payer: Managed Health Services Medicaid	$6,800.84
Rate for Payer: MDWise Medicaid	$6,800.84

APR-DRG 36.00: MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility

$3,198.86

Service Code	APR-DRG 2061
Min. Negotiated Rate	$2,219.96
Max. Negotiated Rate	$3,198.86
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,219.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,219.96
Rate for Payer: Managed Health Services Medicaid	$2,219.96
Rate for Payer: MDWise Medicaid	$2,219.96

APR-DRG 36.00: MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility

$3,847.27

Service Code	APR-DRG 2062
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$3,847.27
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: MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE

Facility

$3,674.36

Service Code	APR-DRG 2522
Min. Negotiated Rate	$3,347.56
Max. Negotiated Rate	$3,674.36
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: MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE

Facility

$5,533.16

Service Code	APR-DRG 2523
Min. Negotiated Rate	$4,757.06
Max. Negotiated Rate	$5,533.16
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: MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE

Facility

$2,809.81

Service Code	APR-DRG 2521
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$2,809.81
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: MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE

Facility

$10,331.44

Service Code	APR-DRG 2524
Min. Negotiated Rate	$6,554.18
Max. Negotiated Rate	$10,331.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,554.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,554.18
Rate for Payer: Managed Health Services Medicaid	$6,554.18
Rate for Payer: MDWise Medicaid	$6,554.18

APR-DRG 36.00: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$8,515.88

Service Code	APR-DRG 4664
Min. Negotiated Rate	$6,977.02
Max. Negotiated Rate	$8,515.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,977.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,977.02
Rate for Payer: Managed Health Services Medicaid	$6,977.02
Rate for Payer: MDWise Medicaid	$6,977.02

APR-DRG 36.00: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$5,057.65

Service Code	APR-DRG 4663
Min. Negotiated Rate	$4,193.26
Max. Negotiated Rate	$5,057.65
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: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$2,507.21

Service Code	APR-DRG 4661
Min. Negotiated Rate	$1,585.69
Max. Negotiated Rate	$2,507.21
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,585.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,585.69
Rate for Payer: Managed Health Services Medicaid	$1,585.69
Rate for Payer: MDWise Medicaid	$1,585.69

APR-DRG 36.00: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$3,198.86

Service Code	APR-DRG 4662
Min. Negotiated Rate	$2,995.19
Max. Negotiated Rate	$3,198.86
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,995.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,995.19
Rate for Payer: Managed Health Services Medicaid	$2,995.19
Rate for Payer: MDWise Medicaid	$2,995.19

APR-DRG 36.00: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$2,809.81

Service Code	APR-DRG 3491
Min. Negotiated Rate	$1,585.69
Max. Negotiated Rate	$2,809.81
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,585.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,585.69
Rate for Payer: Managed Health Services Medicaid	$1,585.69
Rate for Payer: MDWise Medicaid	$1,585.69

APR-DRG 36.00: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$5,391.34

Service Code	APR-DRG 3492
Min. Negotiated Rate	$3,847.27
Max. Negotiated Rate	$5,391.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,391.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,391.34
Rate for Payer: Managed Health Services Medicaid	$5,391.34
Rate for Payer: MDWise Medicaid	$5,391.34

APR-DRG 36.00: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$6,695.12

Service Code	APR-DRG 3493
Min. Negotiated Rate	$5,533.16
Max. Negotiated Rate	$6,695.12
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,695.12
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,695.12
Rate for Payer: Managed Health Services Medicaid	$6,695.12
Rate for Payer: MDWise Medicaid	$6,695.12

APR-DRG 36.00: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$9,164.29

Service Code	APR-DRG 3494
Min. Negotiated Rate	$6,695.12
Max. Negotiated Rate	$9,164.29
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,695.12
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,695.12
Rate for Payer: Managed Health Services Medicaid	$6,695.12
Rate for Payer: MDWise Medicaid	$6,695.12

APR-DRG 36.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$3,155.63

Service Code	APR-DRG 5001
Min. Negotiated Rate	$3,100.90
Max. Negotiated Rate	$3,155.63
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: MALIGNANCY, MALE REPRODUCTIVE SYSTEM

Facility

$3,717.59

Service Code	APR-DRG 5002
Min. Negotiated Rate	$3,100.90
Max. Negotiated Rate	$3,717.59
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

Know your out-of-pocket cost for care.

All Charges