Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: NEONATE BWT <500G OR GA <24 WEEKS

Facility

$68,213.47

Service Code	APR-DRG 5891
Min. Negotiated Rate	$18,464.45
Max. Negotiated Rate	$68,213.47
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,464.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,464.45
Rate for Payer: Managed Health Services Medicaid	$18,464.45
Rate for Payer: MDWise Medicaid	$18,464.45

APR-DRG 36.00: NEONATE BWT <500G OR GA <24 WEEKS

Facility

$68,213.47

Service Code	APR-DRG 5893
Min. Negotiated Rate	$18,464.45
Max. Negotiated Rate	$68,213.47
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,464.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,464.45
Rate for Payer: Managed Health Services Medicaid	$18,464.45
Rate for Payer: MDWise Medicaid	$18,464.45

APR-DRG 36.00: NEONATE BWT <500G OR GA <24 WEEKS

Facility

$18,464.45

Service Code	APR-DRG 5894
Min. Negotiated Rate	$1,426.52
Max. Negotiated Rate	$18,464.45
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,464.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,464.45
Rate for Payer: Managed Health Services Medicaid	$18,464.45
Rate for Payer: MDWise Medicaid	$18,464.45

APR-DRG 36.00: NEONATE BWT <500G OR GA <24 WEEKS

Facility

$68,213.47

Service Code	APR-DRG 5892
Min. Negotiated Rate	$18,464.45
Max. Negotiated Rate	$68,213.47
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,464.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,464.45
Rate for Payer: Managed Health Services Medicaid	$18,464.45
Rate for Payer: MDWise Medicaid	$18,464.45

APR-DRG 36.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$2,420.76

Service Code	APR-DRG 5814
Min. Negotiated Rate	$2,325.68
Max. Negotiated Rate	$2,420.76
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,325.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,325.68
Rate for Payer: Managed Health Services Medicaid	$2,325.68
Rate for Payer: MDWise Medicaid	$2,325.68

APR-DRG 36.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$1,340.06

Service Code	APR-DRG 5813
Min. Negotiated Rate	$1,162.84
Max. Negotiated Rate	$1,340.06
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,162.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,162.84
Rate for Payer: Managed Health Services Medicaid	$1,162.84
Rate for Payer: MDWise Medicaid	$1,162.84

APR-DRG 36.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$704.75

Service Code	APR-DRG 5811
Min. Negotiated Rate	$432.28
Max. Negotiated Rate	$704.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$704.75
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$704.75
Rate for Payer: Managed Health Services Medicaid	$704.75
Rate for Payer: MDWise Medicaid	$704.75

APR-DRG 36.00: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$951.41

Service Code	APR-DRG 5812
Min. Negotiated Rate	$691.64
Max. Negotiated Rate	$951.41
Rate for Payer: Anthem Blue Cross of IN Medicaid	$951.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$951.41
Rate for Payer: Managed Health Services Medicaid	$951.41
Rate for Payer: MDWise Medicaid	$951.41

APR-DRG 36.00: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE

Facility

$3,976.96

Service Code	APR-DRG 5803
Min. Negotiated Rate	$1,973.30
Max. Negotiated Rate	$3,976.96
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,973.30
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,973.30
Rate for Payer: Managed Health Services Medicaid	$1,973.30
Rate for Payer: MDWise Medicaid	$1,973.30

APR-DRG 36.00: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE

Facility

$5,100.88

Service Code	APR-DRG 5804
Min. Negotiated Rate	$1,973.30
Max. Negotiated Rate	$5,100.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,973.30
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,973.30
Rate for Payer: Managed Health Services Medicaid	$1,973.30
Rate for Payer: MDWise Medicaid	$1,973.30

APR-DRG 36.00: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE

Facility

$1,296.83

Service Code	APR-DRG 5801
Min. Negotiated Rate	$916.17
Max. Negotiated Rate	$1,296.83
Rate for Payer: Anthem Blue Cross of IN Medicaid	$916.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$916.17
Rate for Payer: Managed Health Services Medicaid	$916.17
Rate for Payer: MDWise Medicaid	$916.17

APR-DRG 36.00: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE

Facility

$2,031.71

Service Code	APR-DRG 5802
Min. Negotiated Rate	$1,127.60
Max. Negotiated Rate	$2,031.71
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 W ECMO

Facility

$104,481.59

Service Code	APR-DRG 5832
Min. Negotiated Rate	$53,948.61
Max. Negotiated Rate	$104,481.59
Rate for Payer: Anthem Blue Cross of IN Medicaid	$53,948.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$53,948.61
Rate for Payer: Managed Health Services Medicaid	$53,948.61
Rate for Payer: MDWise Medicaid	$53,948.61

APR-DRG 36.00: NEONATE W ECMO

Facility

$136,037.89

Service Code	APR-DRG 5833
Min. Negotiated Rate	$53,948.61
Max. Negotiated Rate	$136,037.89
Rate for Payer: Anthem Blue Cross of IN Medicaid	$53,948.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$53,948.61
Rate for Payer: Managed Health Services Medicaid	$53,948.61
Rate for Payer: MDWise Medicaid	$53,948.61

APR-DRG 36.00: NEONATE W ECMO

Facility

$238,876.82

Service Code	APR-DRG 5834
Min. Negotiated Rate	$53,948.61
Max. Negotiated Rate	$238,876.82
Rate for Payer: Anthem Blue Cross of IN Medicaid	$53,948.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$53,948.61
Rate for Payer: Managed Health Services Medicaid	$53,948.61
Rate for Payer: MDWise Medicaid	$53,948.61

APR-DRG 36.00: NEONATE W ECMO

Facility

$93,761.10

Service Code	APR-DRG 5831
Min. Negotiated Rate	$53,948.61
Max. Negotiated Rate	$93,761.10
Rate for Payer: Anthem Blue Cross of IN Medicaid	$53,948.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$53,948.61
Rate for Payer: Managed Health Services Medicaid	$53,948.61
Rate for Payer: MDWise Medicaid	$53,948.61

APR-DRG 36.00: NEPHRITIS & NEPHROSIS

Facility

$6,657.08

Service Code	APR-DRG 4623
Min. Negotiated Rate	$3,876.12
Max. Negotiated Rate	$6,657.08
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,876.12
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,876.12
Rate for Payer: Managed Health Services Medicaid	$3,876.12
Rate for Payer: MDWise Medicaid	$3,876.12

APR-DRG 36.00: NEPHRITIS & NEPHROSIS

Facility

$3,544.68

Service Code	APR-DRG 4622
Min. Negotiated Rate	$2,255.20
Max. Negotiated Rate	$3,544.68
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: NEPHRITIS & NEPHROSIS

Facility

$2,507.21

Service Code	APR-DRG 4621
Min. Negotiated Rate	$1,691.40
Max. Negotiated Rate	$2,507.21
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,691.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,691.40
Rate for Payer: Managed Health Services Medicaid	$1,691.40
Rate for Payer: MDWise Medicaid	$1,691.40

APR-DRG 36.00: NEPHRITIS & NEPHROSIS

Facility

$11,887.65

Service Code	APR-DRG 4624
Min. Negotiated Rate	$4,862.77
Max. Negotiated Rate	$11,887.65
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,862.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,862.77
Rate for Payer: Managed Health Services Medicaid	$4,862.77
Rate for Payer: MDWise Medicaid	$4,862.77

APR-DRG 36.00: NERVOUS SYSTEM MALIGNANCY

Facility

$3,804.05

Service Code	APR-DRG 0411
Min. Negotiated Rate	$2,537.10
Max. Negotiated Rate	$3,804.05
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,537.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,537.10
Rate for Payer: Managed Health Services Medicaid	$2,537.10
Rate for Payer: MDWise Medicaid	$2,537.10

APR-DRG 36.00: NERVOUS SYSTEM MALIGNANCY

Facility

$8,775.24

Service Code	APR-DRG 0414
Min. Negotiated Rate	$5,285.62
Max. Negotiated Rate	$8,775.24
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,285.62
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,285.62
Rate for Payer: Managed Health Services Medicaid	$5,285.62
Rate for Payer: MDWise Medicaid	$5,285.62

APR-DRG 36.00: NERVOUS SYSTEM MALIGNANCY

Facility

$5,285.62

Service Code	APR-DRG 0412
Min. Negotiated Rate	$4,409.24
Max. Negotiated Rate	$5,285.62
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,285.62
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,285.62
Rate for Payer: Managed Health Services Medicaid	$5,285.62
Rate for Payer: MDWise Medicaid	$5,285.62

APR-DRG 36.00: NERVOUS SYSTEM MALIGNANCY

Facility

$6,095.12

Service Code	APR-DRG 0413
Min. Negotiated Rate	$5,285.62
Max. Negotiated Rate	$6,095.12
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,285.62
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,285.62
Rate for Payer: Managed Health Services Medicaid	$5,285.62
Rate for Payer: MDWise Medicaid	$5,285.62

APR-DRG 36.00: NONBACTERIAL INFECTIONS OF NERVOUS SYSTEM EXC VIRAL MENINGITIS

Facility

$6,311.26

Service Code	APR-DRG 0502
Min. Negotiated Rate	$4,334.21
Max. Negotiated Rate	$6,311.26
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,334.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,334.21
Rate for Payer: Managed Health Services Medicaid	$4,334.21
Rate for Payer: MDWise Medicaid	$4,334.21

Know your out-of-pocket cost for care.

All Charges