Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: NEONATAL AFTERCARE

Facility

$12,755.98

Service Code	APR-DRG 8632
Min. Negotiated Rate	$10,547.58
Max. Negotiated Rate	$12,755.98
Rate for Payer: Anthem Blue Cross of IN Medicaid	$12,755.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$12,755.98
Rate for Payer: Managed Health Services Medicaid	$12,755.98
Rate for Payer: MDWise Medicaid	$12,755.98

APR-DRG 36.00: NEONATAL AFTERCARE

Facility

$39,942.49

Service Code	APR-DRG 8634
Min. Negotiated Rate	$33,898.47
Max. Negotiated Rate	$39,942.49
Rate for Payer: Anthem Blue Cross of IN Medicaid	$33,898.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$33,898.47
Rate for Payer: Managed Health Services Medicaid	$33,898.47
Rate for Payer: MDWise Medicaid	$33,898.47

APR-DRG 36.00: NEONATAL AFTERCARE

Facility

$25,547.19

Service Code	APR-DRG 8633
Min. Negotiated Rate	$20,446.75
Max. Negotiated Rate	$25,547.19
Rate for Payer: Anthem Blue Cross of IN Medicaid	$25,547.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$25,547.19
Rate for Payer: Managed Health Services Medicaid	$25,547.19
Rate for Payer: MDWise Medicaid	$25,547.19

APR-DRG 36.00: NEONATAL AFTERCARE

Facility

$5,792.53

Service Code	APR-DRG 8631
Min. Negotiated Rate	$5,074.20
Max. Negotiated Rate	$5,792.53
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,074.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,074.20
Rate for Payer: Managed Health Services Medicaid	$5,074.20
Rate for Payer: MDWise Medicaid	$5,074.20

APR-DRG 36.00: NEONATE BIRTHWT 10001249G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$20,719.65

Service Code	APR-DRG 6031
Min. Negotiated Rate	$3,501.45
Max. Negotiated Rate	$20,719.65
Rate for Payer: Anthem Blue Cross of IN Medicaid	$20,719.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$20,719.65
Rate for Payer: Managed Health Services Medicaid	$20,719.65
Rate for Payer: MDWise Medicaid	$20,719.65

APR-DRG 36.00: NEONATE BIRTHWT 10001249G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$23,397.70

Service Code	APR-DRG 6032
Min. Negotiated Rate	$21,484.22
Max. Negotiated Rate	$23,397.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,397.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,397.70
Rate for Payer: Managed Health Services Medicaid	$23,397.70
Rate for Payer: MDWise Medicaid	$23,397.70

APR-DRG 36.00: NEONATE BIRTHWT 10001249G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$26,325.73

Service Code	APR-DRG 6033
Min. Negotiated Rate	$23,750.08
Max. Negotiated Rate	$26,325.73
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,750.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,750.08
Rate for Payer: Managed Health Services Medicaid	$23,750.08
Rate for Payer: MDWise Medicaid	$23,750.08

APR-DRG 36.00: NEONATE BIRTHWT 10001249G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$46,469.89

Service Code	APR-DRG 6034
Min. Negotiated Rate	$23,750.08
Max. Negotiated Rate	$46,469.89
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,750.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,750.08
Rate for Payer: Managed Health Services Medicaid	$23,750.08
Rate for Payer: MDWise Medicaid	$23,750.08

APR-DRG 36.00: NEONATE BIRTHWT 15001999G W CONGENITAL/PERINATAL INFECTION

Facility

$21,873.27

Service Code	APR-DRG 6133
Min. Negotiated Rate	$13,284.54
Max. Negotiated Rate	$21,873.27
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,284.54
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,284.54
Rate for Payer: Managed Health Services Medicaid	$13,284.54
Rate for Payer: MDWise Medicaid	$13,284.54

APR-DRG 36.00: NEONATE BIRTHWT 15001999G W CONGENITAL/PERINATAL INFECTION

Facility

$40,461.22

Service Code	APR-DRG 6134
Min. Negotiated Rate	$13,284.54
Max. Negotiated Rate	$40,461.22
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,284.54
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,284.54
Rate for Payer: Managed Health Services Medicaid	$13,284.54
Rate for Payer: MDWise Medicaid	$13,284.54

APR-DRG 36.00: NEONATE BIRTHWT 15001999G W CONGENITAL/PERINATAL INFECTION

Facility

$12,881.88

Service Code	APR-DRG 6132
Min. Negotiated Rate	$9,408.41
Max. Negotiated Rate	$12,881.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,408.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,408.41
Rate for Payer: Managed Health Services Medicaid	$9,408.41
Rate for Payer: MDWise Medicaid	$9,408.41

APR-DRG 36.00: NEONATE BIRTHWT 15001999G W CONGENITAL/PERINATAL INFECTION

Facility

$9,408.41

Service Code	APR-DRG 6131
Min. Negotiated Rate	$8,256.51
Max. Negotiated Rate	$9,408.41
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,408.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,408.41
Rate for Payer: Managed Health Services Medicaid	$9,408.41
Rate for Payer: MDWise Medicaid	$9,408.41

APR-DRG 36.00: NEONATE BIRTHWT 15001999G W MAJOR ANOMALY

Facility

$7,002.90

Service Code	APR-DRG 6111
Min. Negotiated Rate	$6,448.46
Max. Negotiated Rate	$7,002.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,448.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,448.46
Rate for Payer: Managed Health Services Medicaid	$6,448.46
Rate for Payer: MDWise Medicaid	$6,448.46

APR-DRG 36.00: NEONATE BIRTHWT 15001999G W MAJOR ANOMALY

Facility

$20,085.38

Service Code	APR-DRG 6112
Min. Negotiated Rate	$13,400.62
Max. Negotiated Rate	$20,085.38
Rate for Payer: Anthem Blue Cross of IN Medicaid	$20,085.38
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$20,085.38
Rate for Payer: Managed Health Services Medicaid	$20,085.38
Rate for Payer: MDWise Medicaid	$20,085.38

APR-DRG 36.00: NEONATE BIRTHWT 15001999G W MAJOR ANOMALY

Facility

$23,468.17

Service Code	APR-DRG 6113
Min. Negotiated Rate	$21,786.81
Max. Negotiated Rate	$23,468.17
Rate for Payer: Anthem Blue Cross of IN Medicaid	$23,468.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$23,468.17
Rate for Payer: Managed Health Services Medicaid	$23,468.17
Rate for Payer: MDWise Medicaid	$23,468.17

APR-DRG 36.00: NEONATE BIRTHWT 15001999G W MAJOR ANOMALY

Facility

$45,984.94

Service Code	APR-DRG 6114
Min. Negotiated Rate	$40,850.27
Max. Negotiated Rate	$45,984.94
Rate for Payer: Anthem Blue Cross of IN Medicaid	$45,984.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$45,984.94
Rate for Payer: Managed Health Services Medicaid	$45,984.94
Rate for Payer: MDWise Medicaid	$45,984.94

APR-DRG 36.00: NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$2,290.44

Service Code	APR-DRG 6403
Min. Negotiated Rate	$1,599.43
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: NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$1,127.60

Service Code	APR-DRG 6402
Min. Negotiated Rate	$734.87
Max. Negotiated Rate	$1,127.60
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,127.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,127.60
Rate for Payer: Managed Health Services Medicaid	$1,127.60
Rate for Payer: MDWise Medicaid	$1,127.60

APR-DRG 36.00: NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$8,904.93

Service Code	APR-DRG 6404
Min. Negotiated Rate	$2,290.44
Max. Negotiated Rate	$8,904.93
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: NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$880.94

Service Code	APR-DRG 6401
Min. Negotiated Rate	$475.51
Max. Negotiated Rate	$880.94
Rate for Payer: Anthem Blue Cross of IN Medicaid	$880.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$880.94
Rate for Payer: Managed Health Services Medicaid	$880.94
Rate for Payer: MDWise Medicaid	$880.94

APR-DRG 36.00: NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION

Facility

$5,489.93

Service Code	APR-DRG 6362
Min. Negotiated Rate	$4,087.55
Max. Negotiated Rate	$5,489.93
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,087.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,087.55
Rate for Payer: Managed Health Services Medicaid	$4,087.55
Rate for Payer: MDWise Medicaid	$4,087.55

APR-DRG 36.00: NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION

Facility

$4,087.55

Service Code	APR-DRG 6361
Min. Negotiated Rate	$3,371.77
Max. Negotiated Rate	$4,087.55
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,087.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,087.55
Rate for Payer: Managed Health Services Medicaid	$4,087.55
Rate for Payer: MDWise Medicaid	$4,087.55

APR-DRG 36.00: NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION

Facility

$11,412.14

Service Code	APR-DRG 6363
Min. Negotiated Rate	$4,087.55
Max. Negotiated Rate	$11,412.14
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,087.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,087.55
Rate for Payer: Managed Health Services Medicaid	$4,087.55
Rate for Payer: MDWise Medicaid	$4,087.55

APR-DRG 36.00: NEONATE BIRTHWT >2499G W CONGENITAL/PERINATAL INFECTION

Facility

$11,412.14

Service Code	APR-DRG 6364
Min. Negotiated Rate	$4,087.55
Max. Negotiated Rate	$11,412.14
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,087.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,087.55
Rate for Payer: Managed Health Services Medicaid	$4,087.55
Rate for Payer: MDWise Medicaid	$4,087.55

APR-DRG 36.00: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$32,118.26

Service Code	APR-DRG 6334
Min. Negotiated Rate	$26,005.28
Max. Negotiated Rate	$32,118.26
Rate for Payer: Anthem Blue Cross of IN Medicaid	$26,005.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$26,005.28
Rate for Payer: Managed Health Services Medicaid	$26,005.28
Rate for Payer: MDWise Medicaid	$26,005.28

Know your out-of-pocket cost for care.

All Charges