Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES

Facility

$6,342.75

Service Code	APR-DRG 3472
Min. Negotiated Rate	$3,976.96
Max. Negotiated Rate	$6,342.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,342.75
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,342.75
Rate for Payer: Managed Health Services Medicaid	$6,342.75
Rate for Payer: MDWise Medicaid	$6,342.75

APR-DRG 36.00: OTHER BLADDER PROCEDURES

Facility

$4,755.06

Service Code	APR-DRG 4451
Min. Negotiated Rate	$3,100.90
Max. Negotiated Rate	$4,755.06
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,100.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,100.90
Rate for Payer: Managed Health Services Medicaid	$3,100.90
Rate for Payer: MDWise Medicaid	$3,100.90

APR-DRG 36.00: OTHER BLADDER PROCEDURES

Facility

$6,570.63

Service Code	APR-DRG 4452
Min. Negotiated Rate	$3,171.38
Max. Negotiated Rate	$6,570.63
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,171.38
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,171.38
Rate for Payer: Managed Health Services Medicaid	$3,171.38
Rate for Payer: MDWise Medicaid	$3,171.38

APR-DRG 36.00: OTHER BLADDER PROCEDURES

Facility

$13,400.62

Service Code	APR-DRG 4454
Min. Negotiated Rate	$7,470.35
Max. Negotiated Rate	$13,400.62
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,470.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,470.35
Rate for Payer: Managed Health Services Medicaid	$7,470.35
Rate for Payer: MDWise Medicaid	$7,470.35

APR-DRG 36.00: OTHER BLADDER PROCEDURES

Facility

$8,948.15

Service Code	APR-DRG 4453
Min. Negotiated Rate	$5,567.52
Max. Negotiated Rate	$8,948.15
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,567.52
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,567.52
Rate for Payer: Managed Health Services Medicaid	$5,567.52
Rate for Payer: MDWise Medicaid	$5,567.52

APR-DRG 36.00: OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES

Facility

$19,236.37

Service Code	APR-DRG 1673
Min. Negotiated Rate	$13,108.35
Max. Negotiated Rate	$19,236.37
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,108.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,108.35
Rate for Payer: Managed Health Services Medicaid	$13,108.35
Rate for Payer: MDWise Medicaid	$13,108.35

APR-DRG 36.00: OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES

Facility

$30,302.69

Service Code	APR-DRG 1674
Min. Negotiated Rate	$20,931.08
Max. Negotiated Rate	$30,302.69
Rate for Payer: Anthem Blue Cross of IN Medicaid	$20,931.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$20,931.08
Rate for Payer: Managed Health Services Medicaid	$20,931.08
Rate for Payer: MDWise Medicaid	$20,931.08

APR-DRG 36.00: OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES

Facility

$11,152.77

Service Code	APR-DRG 1671
Min. Negotiated Rate	$7,963.68
Max. Negotiated Rate	$11,152.77
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,963.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,963.68
Rate for Payer: Managed Health Services Medicaid	$7,963.68
Rate for Payer: MDWise Medicaid	$7,963.68

APR-DRG 36.00: OTHER CARDIOTHORACIC & THORACIC VASCULAR PROCEDURES

Facility

$14,092.26

Service Code	APR-DRG 1672
Min. Negotiated Rate	$10,359.83
Max. Negotiated Rate	$14,092.26
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,359.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,359.83
Rate for Payer: Managed Health Services Medicaid	$10,359.83
Rate for Payer: MDWise Medicaid	$10,359.83

APR-DRG 36.00: OTHER CHEMOTHERAPY

Facility

$4,236.32

Service Code	APR-DRG 6962
Min. Negotiated Rate	$3,418.04
Max. Negotiated Rate	$4,236.32
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,418.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,418.04
Rate for Payer: Managed Health Services Medicaid	$3,418.04
Rate for Payer: MDWise Medicaid	$3,418.04

APR-DRG 36.00: OTHER CHEMOTHERAPY

Facility

$3,371.77

Service Code	APR-DRG 6961
Min. Negotiated Rate	$2,466.62
Max. Negotiated Rate	$3,371.77
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,466.62
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,466.62
Rate for Payer: Managed Health Services Medicaid	$2,466.62
Rate for Payer: MDWise Medicaid	$2,466.62

APR-DRG 36.00: OTHER CHEMOTHERAPY

Facility

$6,873.22

Service Code	APR-DRG 6963
Min. Negotiated Rate	$5,320.86
Max. Negotiated Rate	$6,873.22
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,320.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,320.86
Rate for Payer: Managed Health Services Medicaid	$5,320.86
Rate for Payer: MDWise Medicaid	$5,320.86

APR-DRG 36.00: OTHER CHEMOTHERAPY

Facility

$12,622.52

Service Code	APR-DRG 6964
Min. Negotiated Rate	$9,655.08
Max. Negotiated Rate	$12,622.52
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,655.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,655.08
Rate for Payer: Managed Health Services Medicaid	$9,655.08
Rate for Payer: MDWise Medicaid	$9,655.08

APR-DRG 36.00: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$8,818.47

Service Code	APR-DRG 2074
Min. Negotiated Rate	$5,673.24
Max. Negotiated Rate	$8,818.47
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,673.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,673.24
Rate for Payer: Managed Health Services Medicaid	$5,673.24
Rate for Payer: MDWise Medicaid	$5,673.24

APR-DRG 36.00: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$2,463.98

Service Code	APR-DRG 2071
Min. Negotiated Rate	$2,184.72
Max. Negotiated Rate	$2,463.98
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,184.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,184.72
Rate for Payer: Managed Health Services Medicaid	$2,184.72
Rate for Payer: MDWise Medicaid	$2,184.72

APR-DRG 36.00: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$5,673.24

Service Code	APR-DRG 2073
Min. Negotiated Rate	$4,711.83
Max. Negotiated Rate	$5,673.24
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,673.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,673.24
Rate for Payer: Managed Health Services Medicaid	$5,673.24
Rate for Payer: MDWise Medicaid	$5,673.24

APR-DRG 36.00: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility

$3,347.56

Service Code	APR-DRG 2072
Min. Negotiated Rate	$3,242.09
Max. Negotiated Rate	$3,347.56
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,347.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,347.56
Rate for Payer: Managed Health Services Medicaid	$3,347.56
Rate for Payer: MDWise Medicaid	$3,347.56

APR-DRG 36.00: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$7,132.59

Service Code	APR-DRG 1802
Min. Negotiated Rate	$5,250.39
Max. Negotiated Rate	$7,132.59
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,250.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,250.39
Rate for Payer: Managed Health Services Medicaid	$5,250.39
Rate for Payer: MDWise Medicaid	$5,250.39

APR-DRG 36.00: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$6,268.03

Service Code	APR-DRG 1801
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$6,268.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,263.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,263.74
Rate for Payer: Managed Health Services Medicaid	$4,263.74
Rate for Payer: MDWise Medicaid	$4,263.74

APR-DRG 36.00: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$10,331.44

Service Code	APR-DRG 1803
Min. Negotiated Rate	$8,386.52
Max. Negotiated Rate	$10,331.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,386.52
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,386.52
Rate for Payer: Managed Health Services Medicaid	$8,386.52
Rate for Payer: MDWise Medicaid	$8,386.52

APR-DRG 36.00: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$16,642.70

Service Code	APR-DRG 1804
Min. Negotiated Rate	$11,064.58
Max. Negotiated Rate	$16,642.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,064.58
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,064.58
Rate for Payer: Managed Health Services Medicaid	$11,064.58
Rate for Payer: MDWise Medicaid	$11,064.58

APR-DRG 36.00: OTHER COMPLICATIONS OF TREATMENT

Facility

$2,636.90

Service Code	APR-DRG 8131
Min. Negotiated Rate	$1,797.11
Max. Negotiated Rate	$2,636.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,797.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,797.11
Rate for Payer: Managed Health Services Medicaid	$1,797.11
Rate for Payer: MDWise Medicaid	$1,797.11

APR-DRG 36.00: OTHER COMPLICATIONS OF TREATMENT

Facility

$5,230.56

Service Code	APR-DRG 8133
Min. Negotiated Rate	$4,017.07
Max. Negotiated Rate	$5,230.56
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,017.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,017.07
Rate for Payer: Managed Health Services Medicaid	$4,017.07
Rate for Payer: MDWise Medicaid	$4,017.07

APR-DRG 36.00: OTHER COMPLICATIONS OF TREATMENT

Facility

$3,587.91

Service Code	APR-DRG 8132
Min. Negotiated Rate	$3,382.80
Max. Negotiated Rate	$3,587.91
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,382.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,382.80
Rate for Payer: Managed Health Services Medicaid	$3,382.80
Rate for Payer: MDWise Medicaid	$3,382.80

APR-DRG 36.00: OTHER COMPLICATIONS OF TREATMENT

Facility

$9,250.75

Service Code	APR-DRG 8134
Min. Negotiated Rate	$6,307.51
Max. Negotiated Rate	$9,250.75
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,307.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,307.51
Rate for Payer: Managed Health Services Medicaid	$6,307.51
Rate for Payer: MDWise Medicaid	$6,307.51

Know your out-of-pocket cost for care.

All Charges