Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

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

Facility

$7,012.26

Service Code	APR-DRG 6332
Min. Negotiated Rate	$4,711.83
Max. Negotiated Rate	$7,012.26
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: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$13,495.96

Service Code	APR-DRG 6333
Min. Negotiated Rate	$12,190.24
Max. Negotiated Rate	$13,495.96
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,495.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,495.96
Rate for Payer: Managed Health Services Medicaid	$13,495.96
Rate for Payer: MDWise Medicaid	$13,495.96

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

Facility

$13,777.86

Service Code	APR-DRG 6301
Min. Negotiated Rate	$11,585.05
Max. Negotiated Rate	$13,777.86
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: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$88,919.58

Service Code	APR-DRG 6304
Min. Negotiated Rate	$51,129.61
Max. Negotiated Rate	$88,919.58
Rate for Payer: Anthem Blue Cross of IN Medicaid	$51,129.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$51,129.61
Rate for Payer: Managed Health Services Medicaid	$51,129.61
Rate for Payer: MDWise Medicaid	$51,129.61

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

Facility

$22,348.77

Service Code	APR-DRG 6302
Min. Negotiated Rate	$13,777.86
Max. Negotiated Rate	$22,348.77
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: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$49,020.33

Service Code	APR-DRG 6303
Min. Negotiated Rate	$13,777.86
Max. Negotiated Rate	$49,020.33
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: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$4,510.40

Service Code	APR-DRG 6311
Min. Negotiated Rate	$3,328.54
Max. Negotiated Rate	$4,510.40
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,510.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,510.40
Rate for Payer: Managed Health Services Medicaid	$4,510.40
Rate for Payer: MDWise Medicaid	$4,510.40

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

Facility

$16,599.48

Service Code	APR-DRG 6312
Min. Negotiated Rate	$12,333.12
Max. Negotiated Rate	$16,599.48
Rate for Payer: Anthem Blue Cross of IN Medicaid	$12,333.12
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$12,333.12
Rate for Payer: Managed Health Services Medicaid	$12,333.12
Rate for Payer: MDWise Medicaid	$12,333.12

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

Facility

$28,832.94

Service Code	APR-DRG 6313
Min. Negotiated Rate	$13,178.83
Max. Negotiated Rate	$28,832.94
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,178.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,178.83
Rate for Payer: Managed Health Services Medicaid	$13,178.83
Rate for Payer: MDWise Medicaid	$13,178.83

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

Facility

$98,040.65

Service Code	APR-DRG 6314
Min. Negotiated Rate	$51,693.41
Max. Negotiated Rate	$98,040.65
Rate for Payer: Anthem Blue Cross of IN Medicaid	$51,693.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$51,693.41
Rate for Payer: Managed Health Services Medicaid	$51,693.41
Rate for Payer: MDWise Medicaid	$51,693.41

APR-DRG 36.00: NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION

Facility

$11,416.95

Service Code	APR-DRG 6393
Min. Negotiated Rate	$9,034.61
Max. Negotiated Rate	$11,416.95
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,416.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,416.95
Rate for Payer: Managed Health Services Medicaid	$11,416.95
Rate for Payer: MDWise Medicaid	$11,416.95

APR-DRG 36.00: NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION

Facility

$13,573.53

Service Code	APR-DRG 6394
Min. Negotiated Rate	$11,416.95
Max. Negotiated Rate	$13,573.53
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,416.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,416.95
Rate for Payer: Managed Health Services Medicaid	$11,416.95
Rate for Payer: MDWise Medicaid	$11,416.95

APR-DRG 36.00: NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION

Facility

$5,179.91

Service Code	APR-DRG 6391
Min. Negotiated Rate	$1,599.43
Max. Negotiated Rate	$5,179.91
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,179.91
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,179.91
Rate for Payer: Managed Health Services Medicaid	$5,179.91
Rate for Payer: MDWise Medicaid	$5,179.91

APR-DRG 36.00: NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION

Facility

$8,210.34

Service Code	APR-DRG 6392
Min. Negotiated Rate	$3,069.17
Max. Negotiated Rate	$8,210.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,210.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,210.34
Rate for Payer: Managed Health Services Medicaid	$8,210.34
Rate for Payer: MDWise Medicaid	$8,210.34

APR-DRG 36.00: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$7,329.40

Service Code	APR-DRG 6342
Min. Negotiated Rate	$5,100.88
Max. Negotiated Rate	$7,329.40
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: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$3,594.22

Service Code	APR-DRG 6341
Min. Negotiated Rate	$3,112.40
Max. Negotiated Rate	$3,594.22
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: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$10,158.53

Service Code	APR-DRG 6343
Min. Negotiated Rate	$10,042.69
Max. Negotiated Rate	$10,158.53
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,042.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,042.69
Rate for Payer: Managed Health Services Medicaid	$10,042.69
Rate for Payer: MDWise Medicaid	$10,042.69

APR-DRG 36.00: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$19,452.51

Service Code	APR-DRG 6344
Min. Negotiated Rate	$19,028.25
Max. Negotiated Rate	$19,452.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$19,028.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$19,028.25
Rate for Payer: Managed Health Services Medicaid	$19,028.25
Rate for Payer: MDWise Medicaid	$19,028.25

APR-DRG 36.00: NEONATE BIRTHWT 500749G W/O MAJOR PROCEDURE

Facility

$62,075.12

Service Code	APR-DRG 5912
Min. Negotiated Rate	$29,106.17
Max. Negotiated Rate	$62,075.12
Rate for Payer: Anthem Blue Cross of IN Medicaid	$29,106.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$29,106.17
Rate for Payer: Managed Health Services Medicaid	$29,106.17
Rate for Payer: MDWise Medicaid	$29,106.17

APR-DRG 36.00: NEONATE BIRTHWT 500749G W/O MAJOR PROCEDURE

Facility

$29,106.17

Service Code	APR-DRG 5911
Min. Negotiated Rate	$13,184.48
Max. Negotiated Rate	$29,106.17
Rate for Payer: Anthem Blue Cross of IN Medicaid	$29,106.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$29,106.17
Rate for Payer: Managed Health Services Medicaid	$29,106.17
Rate for Payer: MDWise Medicaid	$29,106.17

APR-DRG 36.00: NEONATE BIRTHWT 500749G W/O MAJOR PROCEDURE

Facility

$72,363.34

Service Code	APR-DRG 5913
Min. Negotiated Rate	$29,106.17
Max. Negotiated Rate	$72,363.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$29,106.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$29,106.17
Rate for Payer: Managed Health Services Medicaid	$29,106.17
Rate for Payer: MDWise Medicaid	$29,106.17

APR-DRG 36.00: NEONATE BIRTHWT 500749G W/O MAJOR PROCEDURE

Facility

$95,922.49

Service Code	APR-DRG 5914
Min. Negotiated Rate	$63,638.93
Max. Negotiated Rate	$95,922.49
Rate for Payer: Anthem Blue Cross of IN Medicaid	$63,638.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$63,638.93
Rate for Payer: Managed Health Services Medicaid	$63,638.93
Rate for Payer: MDWise Medicaid	$63,638.93

APR-DRG 36.00: NEONATE BIRTHWT 750999G W/O MAJOR PROCEDURE

Facility

$61,686.07

Service Code	APR-DRG 5933
Min. Negotiated Rate	$45,104.00
Max. Negotiated Rate	$61,686.07
Rate for Payer: Anthem Blue Cross of IN Medicaid	$45,104.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$45,104.00
Rate for Payer: Managed Health Services Medicaid	$45,104.00
Rate for Payer: MDWise Medicaid	$45,104.00

APR-DRG 36.00: NEONATE BIRTHWT 750999G W/O MAJOR PROCEDURE

Facility

$49,625.51

Service Code	APR-DRG 5932
Min. Negotiated Rate	$28,436.66
Max. Negotiated Rate	$49,625.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$28,436.66
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$28,436.66
Rate for Payer: Managed Health Services Medicaid	$28,436.66
Rate for Payer: MDWise Medicaid	$28,436.66

Know your out-of-pocket cost for care.

All Charges