Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$37,781.10

Service Code	APR-DRG 5931
Min. Negotiated Rate	$28,436.66
Max. Negotiated Rate	$37,781.10
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

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

APR-DRG 36.00: NEONATE BWT 10001249G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM

Facility

$26,674.79

Service Code	APR-DRG 6021
Min. Negotiated Rate	$26,282.50
Max. Negotiated Rate	$26,674.79
Rate for Payer: Anthem Blue Cross of IN Medicaid	$26,674.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$26,674.79
Rate for Payer: Managed Health Services Medicaid	$26,674.79
Rate for Payer: MDWise Medicaid	$26,674.79

APR-DRG 36.00: NEONATE BWT 10001249G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM

Facility

$35,273.88

Service Code	APR-DRG 6022
Min. Negotiated Rate	$26,674.79
Max. Negotiated Rate	$35,273.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$26,674.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$26,674.79
Rate for Payer: Managed Health Services Medicaid	$26,674.79
Rate for Payer: MDWise Medicaid	$26,674.79

APR-DRG 36.00: NEONATE BWT 10001249G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM

Facility

$44,135.58

Service Code	APR-DRG 6023
Min. Negotiated Rate	$37,563.18
Max. Negotiated Rate	$44,135.58
Rate for Payer: Anthem Blue Cross of IN Medicaid	$37,563.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$37,563.18
Rate for Payer: Managed Health Services Medicaid	$37,563.18
Rate for Payer: MDWise Medicaid	$37,563.18

APR-DRG 36.00: NEONATE BWT 10001249G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM

Facility

$63,544.87

Service Code	APR-DRG 6024
Min. Negotiated Rate	$40,664.07
Max. Negotiated Rate	$63,544.87
Rate for Payer: Anthem Blue Cross of IN Medicaid	$40,664.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$40,664.07
Rate for Payer: Managed Health Services Medicaid	$40,664.07
Rate for Payer: MDWise Medicaid	$40,664.07

APR-DRG 36.00: NEONATE BWT 12501499G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$28,011.61

Service Code	APR-DRG 6084
Min. Negotiated Rate	$24,349.11
Max. Negotiated Rate	$28,011.61
Rate for Payer: Anthem Blue Cross of IN Medicaid	$24,349.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$24,349.11
Rate for Payer: Managed Health Services Medicaid	$24,349.11
Rate for Payer: MDWise Medicaid	$24,349.11

APR-DRG 36.00: NEONATE BWT 12501499G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$17,548.28

Service Code	APR-DRG 6082
Min. Negotiated Rate	$16,729.16
Max. Negotiated Rate	$17,548.28
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,548.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,548.28
Rate for Payer: Managed Health Services Medicaid	$17,548.28
Rate for Payer: MDWise Medicaid	$17,548.28

APR-DRG 36.00: NEONATE BWT 12501499G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$11,593.14

Service Code	APR-DRG 6081
Min. Negotiated Rate	$9,639.80
Max. Negotiated Rate	$11,593.14
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,593.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,593.14
Rate for Payer: Managed Health Services Medicaid	$11,593.14
Rate for Payer: MDWise Medicaid	$11,593.14

APR-DRG 36.00: NEONATE BWT 12501499G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$24,349.11

Service Code	APR-DRG 6083
Min. Negotiated Rate	$24,164.34
Max. Negotiated Rate	$24,349.11
Rate for Payer: Anthem Blue Cross of IN Medicaid	$24,349.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$24,349.11
Rate for Payer: Managed Health Services Medicaid	$24,349.11
Rate for Payer: MDWise Medicaid	$24,349.11

APR-DRG 36.00: NEONATE BWT 12501499G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM

Facility

$26,463.36

Service Code	APR-DRG 6072
Min. Negotiated Rate	$25,158.58
Max. Negotiated Rate	$26,463.36
Rate for Payer: Anthem Blue Cross of IN Medicaid	$26,463.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$26,463.36
Rate for Payer: Managed Health Services Medicaid	$26,463.36
Rate for Payer: MDWise Medicaid	$26,463.36

APR-DRG 36.00: NEONATE BWT 12501499G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM

Facility

$33,674.46

Service Code	APR-DRG 6073
Min. Negotiated Rate	$28,683.33
Max. Negotiated Rate	$33,674.46
Rate for Payer: Anthem Blue Cross of IN Medicaid	$28,683.33
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$28,683.33
Rate for Payer: Managed Health Services Medicaid	$28,683.33
Rate for Payer: MDWise Medicaid	$28,683.33

APR-DRG 36.00: NEONATE BWT 12501499G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM

Facility

$49,106.78

Service Code	APR-DRG 6074
Min. Negotiated Rate	$39,571.71
Max. Negotiated Rate	$49,106.78
Rate for Payer: Anthem Blue Cross of IN Medicaid	$39,571.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$39,571.71
Rate for Payer: Managed Health Services Medicaid	$39,571.71
Rate for Payer: MDWise Medicaid	$39,571.71

APR-DRG 36.00: NEONATE BWT 12501499G W RESP DIST SYND/OTH MAJ RESP OR MAJ ANOM

Facility

$17,982.76

Service Code	APR-DRG 6071
Min. Negotiated Rate	$13,777.86
Max. Negotiated Rate	$17,982.76
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 BWT 15001999G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$27,017.38

Service Code	APR-DRG 6144
Min. Negotiated Rate	$17,125.42
Max. Negotiated Rate	$27,017.38
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,125.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,125.42
Rate for Payer: Managed Health Services Medicaid	$17,125.42
Rate for Payer: MDWise Medicaid	$17,125.42

APR-DRG 36.00: NEONATE BWT 15001999G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$11,910.27

Service Code	APR-DRG 6142
Min. Negotiated Rate	$10,547.58
Max. Negotiated Rate	$11,910.27
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,910.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,910.27
Rate for Payer: Managed Health Services Medicaid	$11,910.27
Rate for Payer: MDWise Medicaid	$11,910.27

APR-DRG 36.00: NEONATE BWT 15001999G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$18,242.13

Service Code	APR-DRG 6143
Min. Negotiated Rate	$17,125.42
Max. Negotiated Rate	$18,242.13
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,125.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,125.42
Rate for Payer: Managed Health Services Medicaid	$17,125.42
Rate for Payer: MDWise Medicaid	$17,125.42

APR-DRG 36.00: NEONATE BWT 15001999G W OR W/O OTHER SIGNIFICANT CONDITION

Facility

$6,871.31

Service Code	APR-DRG 6141
Min. Negotiated Rate	$5,446.70
Max. Negotiated Rate	$6,871.31
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,871.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,871.31
Rate for Payer: Managed Health Services Medicaid	$6,871.31
Rate for Payer: MDWise Medicaid	$6,871.31

APR-DRG 36.00: NEONATE BWT 15001999G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$11,698.85

Service Code	APR-DRG 6121
Min. Negotiated Rate	$10,763.72
Max. Negotiated Rate	$11,698.85
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,698.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,698.85
Rate for Payer: Managed Health Services Medicaid	$11,698.85
Rate for Payer: MDWise Medicaid	$11,698.85

APR-DRG 36.00: NEONATE BWT 15001999G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$22,340.58

Service Code	APR-DRG 6123
Min. Negotiated Rate	$22,305.54
Max. Negotiated Rate	$22,340.58
Rate for Payer: Anthem Blue Cross of IN Medicaid	$22,340.58
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$22,340.58
Rate for Payer: Managed Health Services Medicaid	$22,340.58
Rate for Payer: MDWise Medicaid	$22,340.58

APR-DRG 36.00: NEONATE BWT 15001999G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$16,984.47

Service Code	APR-DRG 6122
Min. Negotiated Rate	$15,605.24
Max. Negotiated Rate	$16,984.47
Rate for Payer: Anthem Blue Cross of IN Medicaid	$16,984.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$16,984.47
Rate for Payer: Managed Health Services Medicaid	$16,984.47
Rate for Payer: MDWise Medicaid	$16,984.47

APR-DRG 36.00: NEONATE BWT 15001999G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$32,161.48

Service Code	APR-DRG 6124
Min. Negotiated Rate	$25,089.10
Max. Negotiated Rate	$32,161.48
Rate for Payer: Anthem Blue Cross of IN Medicaid	$25,089.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$25,089.10
Rate for Payer: Managed Health Services Medicaid	$25,089.10
Rate for Payer: MDWise Medicaid	$25,089.10

APR-DRG 36.00: NEONATE BWT 15002499G W MAJOR PROCEDURE

Facility

$31,713.75

Service Code	APR-DRG 6092
Min. Negotiated Rate	$23,083.65
Max. Negotiated Rate	$31,713.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$31,713.75
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$31,713.75
Rate for Payer: Managed Health Services Medicaid	$31,713.75
Rate for Payer: MDWise Medicaid	$31,713.75

APR-DRG 36.00: NEONATE BWT 15002499G W MAJOR PROCEDURE

Facility

$31,713.75

Service Code	APR-DRG 6091
Min. Negotiated Rate	$18,544.73
Max. Negotiated Rate	$31,713.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$31,713.75
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$31,713.75
Rate for Payer: Managed Health Services Medicaid	$31,713.75
Rate for Payer: MDWise Medicaid	$31,713.75

APR-DRG 36.00: NEONATE BWT 15002499G W MAJOR PROCEDURE

Facility

$101,931.15

Service Code	APR-DRG 6094
Min. Negotiated Rate	$60,291.36
Max. Negotiated Rate	$101,931.15
Rate for Payer: Anthem Blue Cross of IN Medicaid	$60,291.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$60,291.36
Rate for Payer: Managed Health Services Medicaid	$60,291.36
Rate for Payer: MDWise Medicaid	$60,291.36

Know your out-of-pocket cost for care.

All Charges