Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$35,360.34

Service Code	APR-DRG 6093
Min. Negotiated Rate	$31,713.75
Max. Negotiated Rate	$35,360.34
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 <1500G W MAJOR PROCEDURE

Facility

$71,585.24

Service Code	APR-DRG 5881
Min. Negotiated Rate	$47,887.76
Max. Negotiated Rate	$71,585.24
Rate for Payer: Anthem Blue Cross of IN Medicaid	$47,887.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$47,887.76
Rate for Payer: Managed Health Services Medicaid	$47,887.76
Rate for Payer: MDWise Medicaid	$47,887.76

APR-DRG 36.00: NEONATE BWT <1500G W MAJOR PROCEDURE

Facility

$97,435.46

Service Code	APR-DRG 5883
Min. Negotiated Rate	$47,887.76
Max. Negotiated Rate	$97,435.46
Rate for Payer: Anthem Blue Cross of IN Medicaid	$47,887.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$47,887.76
Rate for Payer: Managed Health Services Medicaid	$47,887.76
Rate for Payer: MDWise Medicaid	$47,887.76

APR-DRG 36.00: NEONATE BWT <1500G W MAJOR PROCEDURE

Facility

$146,326.10

Service Code	APR-DRG 5884
Min. Negotiated Rate	$109,412.44
Max. Negotiated Rate	$146,326.10
Rate for Payer: Anthem Blue Cross of IN Medicaid	$109,412.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$109,412.44
Rate for Payer: Managed Health Services Medicaid	$109,412.44
Rate for Payer: MDWise Medicaid	$109,412.44

APR-DRG 36.00: NEONATE BWT <1500G W MAJOR PROCEDURE

Facility

$83,516.11

Service Code	APR-DRG 5882
Min. Negotiated Rate	$47,887.76
Max. Negotiated Rate	$83,516.11
Rate for Payer: Anthem Blue Cross of IN Medicaid	$47,887.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$47,887.76
Rate for Payer: Managed Health Services Medicaid	$47,887.76
Rate for Payer: MDWise Medicaid	$47,887.76

APR-DRG 36.00: NEONATE BWT 20002499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$4,475.16

Service Code	APR-DRG 6263
Min. Negotiated Rate	$4,106.64
Max. Negotiated Rate	$4,475.16
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,475.16
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,475.16
Rate for Payer: Managed Health Services Medicaid	$4,475.16
Rate for Payer: MDWise Medicaid	$4,475.16

APR-DRG 36.00: NEONATE BWT 20002499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$1,620.92

Service Code	APR-DRG 6262
Min. Negotiated Rate	$1,426.52
Max. Negotiated Rate	$1,620.92
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,620.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,620.92
Rate for Payer: Managed Health Services Medicaid	$1,620.92
Rate for Payer: MDWise Medicaid	$1,620.92

APR-DRG 36.00: NEONATE BWT 20002499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$8,256.51

Service Code	APR-DRG 6264
Min. Negotiated Rate	$4,475.16
Max. Negotiated Rate	$8,256.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,475.16
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,475.16
Rate for Payer: Managed Health Services Medicaid	$4,475.16
Rate for Payer: MDWise Medicaid	$4,475.16

APR-DRG 36.00: NEONATE BWT 20002499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$1,620.92

Service Code	APR-DRG 6261
Min. Negotiated Rate	$648.42
Max. Negotiated Rate	$1,620.92
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,620.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,620.92
Rate for Payer: Managed Health Services Medicaid	$1,620.92
Rate for Payer: MDWise Medicaid	$1,620.92

APR-DRG 36.00: NEONATE BWT 20002499G W CONGENITAL/PERINATAL INFECTION

Facility

$4,927.97

Service Code	APR-DRG 6231
Min. Negotiated Rate	$3,629.46
Max. Negotiated Rate	$4,927.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,629.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,629.46
Rate for Payer: Managed Health Services Medicaid	$3,629.46
Rate for Payer: MDWise Medicaid	$3,629.46

APR-DRG 36.00: NEONATE BWT 20002499G W CONGENITAL/PERINATAL INFECTION

Facility

$22,564.91

Service Code	APR-DRG 6234
Min. Negotiated Rate	$7,082.74
Max. Negotiated Rate	$22,564.91
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,082.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,082.74
Rate for Payer: Managed Health Services Medicaid	$7,082.74
Rate for Payer: MDWise Medicaid	$7,082.74

APR-DRG 36.00: NEONATE BWT 20002499G W CONGENITAL/PERINATAL INFECTION

Facility

$8,515.88

Service Code	APR-DRG 6232
Min. Negotiated Rate	$7,082.74
Max. Negotiated Rate	$8,515.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,082.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,082.74
Rate for Payer: Managed Health Services Medicaid	$7,082.74
Rate for Payer: MDWise Medicaid	$7,082.74

APR-DRG 36.00: NEONATE BWT 20002499G W CONGENITAL/PERINATAL INFECTION

Facility

$16,945.30

Service Code	APR-DRG 6233
Min. Negotiated Rate	$7,082.74
Max. Negotiated Rate	$16,945.30
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,082.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,082.74
Rate for Payer: Managed Health Services Medicaid	$7,082.74
Rate for Payer: MDWise Medicaid	$7,082.74

APR-DRG 36.00: NEONATE BWT 20002499G W MAJOR ANOMALY

Facility

$4,580.88

Service Code	APR-DRG 6211
Min. Negotiated Rate	$2,636.90
Max. Negotiated Rate	$4,580.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,580.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,580.88
Rate for Payer: Managed Health Services Medicaid	$4,580.88
Rate for Payer: MDWise Medicaid	$4,580.88

APR-DRG 36.00: NEONATE BWT 20002499G W MAJOR ANOMALY

Facility

$7,953.92

Service Code	APR-DRG 6212
Min. Negotiated Rate	$7,082.74
Max. Negotiated Rate	$7,953.92
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,082.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,082.74
Rate for Payer: Managed Health Services Medicaid	$7,082.74
Rate for Payer: MDWise Medicaid	$7,082.74

APR-DRG 36.00: NEONATE BWT 20002499G W MAJOR ANOMALY

Facility

$15,864.60

Service Code	APR-DRG 6213
Min. Negotiated Rate	$14,940.70
Max. Negotiated Rate	$15,864.60
Rate for Payer: Anthem Blue Cross of IN Medicaid	$14,940.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$14,940.70
Rate for Payer: Managed Health Services Medicaid	$14,940.70
Rate for Payer: MDWise Medicaid	$14,940.70

APR-DRG 36.00: NEONATE BWT 20002499G W MAJOR ANOMALY

Facility

$37,739.36

Service Code	APR-DRG 6214
Min. Negotiated Rate	$31,556.29
Max. Negotiated Rate	$37,739.36
Rate for Payer: Anthem Blue Cross of IN Medicaid	$37,739.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$37,739.36
Rate for Payer: Managed Health Services Medicaid	$37,739.36
Rate for Payer: MDWise Medicaid	$37,739.36

APR-DRG 36.00: NEONATE BWT 20002499G W OTHER SIGNIFICANT CONDITION

Facility

$27,968.39

Service Code	APR-DRG 6254
Min. Negotiated Rate	$9,936.98
Max. Negotiated Rate	$27,968.39
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,936.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,936.98
Rate for Payer: Managed Health Services Medicaid	$9,936.98
Rate for Payer: MDWise Medicaid	$9,936.98

APR-DRG 36.00: NEONATE BWT 20002499G W OTHER SIGNIFICANT CONDITION

Facility

$9,936.98

Service Code	APR-DRG 6251
Min. Negotiated Rate	$5,317.02
Max. Negotiated Rate	$9,936.98
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,936.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,936.98
Rate for Payer: Managed Health Services Medicaid	$9,936.98
Rate for Payer: MDWise Medicaid	$9,936.98

APR-DRG 36.00: NEONATE BWT 20002499G W OTHER SIGNIFICANT CONDITION

Facility

$12,838.66

Service Code	APR-DRG 6253
Min. Negotiated Rate	$9,936.98
Max. Negotiated Rate	$12,838.66
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,936.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,936.98
Rate for Payer: Managed Health Services Medicaid	$9,936.98
Rate for Payer: MDWise Medicaid	$9,936.98

APR-DRG 36.00: NEONATE BWT 20002499G W OTHER SIGNIFICANT CONDITION

Facility

$9,936.98

Service Code	APR-DRG 6252
Min. Negotiated Rate	$7,737.78
Max. Negotiated Rate	$9,936.98
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,936.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,936.98
Rate for Payer: Managed Health Services Medicaid	$9,936.98
Rate for Payer: MDWise Medicaid	$9,936.98

APR-DRG 36.00: NEONATE BWT 20002499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$14,005.81

Service Code	APR-DRG 6223
Min. Negotiated Rate	$13,249.30
Max. Negotiated Rate	$14,005.81
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,249.30
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,249.30
Rate for Payer: Managed Health Services Medicaid	$13,249.30
Rate for Payer: MDWise Medicaid	$13,249.30

APR-DRG 36.00: NEONATE BWT 20002499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$20,879.03

Service Code	APR-DRG 6224
Min. Negotiated Rate	$20,296.80
Max. Negotiated Rate	$20,879.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$20,296.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$20,296.80
Rate for Payer: Managed Health Services Medicaid	$20,296.80
Rate for Payer: MDWise Medicaid	$20,296.80

APR-DRG 36.00: NEONATE BWT 20002499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$11,875.04

Service Code	APR-DRG 6222
Min. Negotiated Rate	$9,812.71
Max. Negotiated Rate	$11,875.04
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,875.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,875.04
Rate for Payer: Managed Health Services Medicaid	$11,875.04
Rate for Payer: MDWise Medicaid	$11,875.04

APR-DRG 36.00: NEONATE BWT 20002499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$8,668.42

Service Code	APR-DRG 6221
Min. Negotiated Rate	$6,786.76
Max. Negotiated Rate	$8,668.42
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,668.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,668.42
Rate for Payer: Managed Health Services Medicaid	$8,668.42
Rate for Payer: MDWise Medicaid	$8,668.42

Know your out-of-pocket cost for care.

All Charges