Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: OTHER INFECTIOUS & PARASITIC DISEASES

Facility

$6,554.18

Service Code	APR-DRG 7243
Min. Negotiated Rate	$5,360.25
Max. Negotiated Rate	$6,554.18
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,554.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,554.18
Rate for Payer: Managed Health Services Medicaid	$6,554.18
Rate for Payer: MDWise Medicaid	$6,554.18

APR-DRG 36.00: OTHER INFECTIOUS & PARASITIC DISEASES

Facility

$10,547.58

Service Code	APR-DRG 7244
Min. Negotiated Rate	$8,280.81
Max. Negotiated Rate	$10,547.58
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,280.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,280.81
Rate for Payer: Managed Health Services Medicaid	$8,280.81
Rate for Payer: MDWise Medicaid	$8,280.81

APR-DRG 36.00: OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES

Facility

$3,025.95

Service Code	APR-DRG 8152
Min. Negotiated Rate	$2,184.72
Max. Negotiated Rate	$3,025.95
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 INJURY, POISONING & TOXIC EFFECT DIAGNOSES

Facility

$5,057.65

Service Code	APR-DRG 8153
Min. Negotiated Rate	$2,748.53
Max. Negotiated Rate	$5,057.65
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,748.53
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,748.53
Rate for Payer: Managed Health Services Medicaid	$2,748.53
Rate for Payer: MDWise Medicaid	$2,748.53

APR-DRG 36.00: OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES

Facility

$1,988.48

Service Code	APR-DRG 8151
Min. Negotiated Rate	$1,550.45
Max. Negotiated Rate	$1,988.48
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,550.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,550.45
Rate for Payer: Managed Health Services Medicaid	$1,550.45
Rate for Payer: MDWise Medicaid	$1,550.45

APR-DRG 36.00: OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES

Facility

$10,720.49

Service Code	APR-DRG 8154
Min. Negotiated Rate	$6,765.60
Max. Negotiated Rate	$10,720.49
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,765.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,765.60
Rate for Payer: Managed Health Services Medicaid	$6,765.60
Rate for Payer: MDWise Medicaid	$6,765.60

APR-DRG 36.00: OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$2,537.10

Service Code	APR-DRG 4681
Min. Negotiated Rate	$2,420.76
Max. Negotiated Rate	$2,537.10
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: OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$4,841.51

Service Code	APR-DRG 4683
Min. Negotiated Rate	$4,545.64
Max. Negotiated Rate	$4,841.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,545.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,545.64
Rate for Payer: Managed Health Services Medicaid	$4,545.64
Rate for Payer: MDWise Medicaid	$4,545.64

APR-DRG 36.00: OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$4,017.07

Service Code	APR-DRG 4682
Min. Negotiated Rate	$3,112.40
Max. Negotiated Rate	$4,017.07
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 KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$8,559.10

Service Code	APR-DRG 4684
Min. Negotiated Rate	$5,461.81
Max. Negotiated Rate	$8,559.10
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,461.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,461.81
Rate for Payer: Managed Health Services Medicaid	$5,461.81
Rate for Payer: MDWise Medicaid	$5,461.81

APR-DRG 36.00: OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES

Facility

$5,749.30

Service Code	APR-DRG 4471
Min. Negotiated Rate	$5,179.91
Max. Negotiated Rate	$5,749.30
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: OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES

Facility

$7,089.36

Service Code	APR-DRG 4472
Min. Negotiated Rate	$5,743.71
Max. Negotiated Rate	$7,089.36
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,743.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,743.71
Rate for Payer: Managed Health Services Medicaid	$5,743.71
Rate for Payer: MDWise Medicaid	$5,743.71

APR-DRG 36.00: OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES

Facility

$10,590.81

Service Code	APR-DRG 4473
Min. Negotiated Rate	$7,752.25
Max. Negotiated Rate	$10,590.81
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,752.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,752.25
Rate for Payer: Managed Health Services Medicaid	$7,752.25
Rate for Payer: MDWise Medicaid	$7,752.25

APR-DRG 36.00: OTHER KIDNEY, URINARY TRACT & RELATED PROCEDURES

Facility

$18,501.50

Service Code	APR-DRG 4474
Min. Negotiated Rate	$8,774.14
Max. Negotiated Rate	$18,501.50
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,774.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,774.14
Rate for Payer: Managed Health Services Medicaid	$8,774.14
Rate for Payer: MDWise Medicaid	$8,774.14

APR-DRG 36.00: OTHER MAJOR HEAD & NECK PROCEDURES

Facility

$27,060.60

Service Code	APR-DRG 0914
Min. Negotiated Rate	$17,830.17
Max. Negotiated Rate	$27,060.60
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,830.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,830.17
Rate for Payer: Managed Health Services Medicaid	$17,830.17
Rate for Payer: MDWise Medicaid	$17,830.17

APR-DRG 36.00: OTHER MAJOR HEAD & NECK PROCEDURES

Facility

$18,069.22

Service Code	APR-DRG 0913
Min. Negotiated Rate	$10,183.64
Max. Negotiated Rate	$18,069.22
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,183.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,183.64
Rate for Payer: Managed Health Services Medicaid	$10,183.64
Rate for Payer: MDWise Medicaid	$10,183.64

APR-DRG 36.00: OTHER MAJOR HEAD & NECK PROCEDURES

Facility

$12,103.78

Service Code	APR-DRG 0912
Min. Negotiated Rate	$7,188.45
Max. Negotiated Rate	$12,103.78
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,188.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,188.45
Rate for Payer: Managed Health Services Medicaid	$7,188.45
Rate for Payer: MDWise Medicaid	$7,188.45

APR-DRG 36.00: OTHER MAJOR HEAD & NECK PROCEDURES

Facility

$7,564.86

Service Code	APR-DRG 0911
Min. Negotiated Rate	$6,589.41
Max. Negotiated Rate	$7,564.86
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,589.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,589.41
Rate for Payer: Managed Health Services Medicaid	$6,589.41
Rate for Payer: MDWise Medicaid	$6,589.41

APR-DRG 36.00: OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$10,374.67

Service Code	APR-DRG 4843
Min. Negotiated Rate	$5,778.95
Max. Negotiated Rate	$10,374.67
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,778.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,778.95
Rate for Payer: Managed Health Services Medicaid	$5,778.95
Rate for Payer: MDWise Medicaid	$5,778.95

APR-DRG 36.00: OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$5,273.79

Service Code	APR-DRG 4841
Min. Negotiated Rate	$3,206.61
Max. Negotiated Rate	$5,273.79
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,206.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,206.61
Rate for Payer: Managed Health Services Medicaid	$3,206.61
Rate for Payer: MDWise Medicaid	$3,206.61

APR-DRG 36.00: OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$18,977.00

Service Code	APR-DRG 4844
Min. Negotiated Rate	$12,403.60
Max. Negotiated Rate	$18,977.00
Rate for Payer: Anthem Blue Cross of IN Medicaid	$12,403.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$12,403.60
Rate for Payer: Managed Health Services Medicaid	$12,403.60
Rate for Payer: MDWise Medicaid	$12,403.60

APR-DRG 36.00: OTHER MALE REPRODUCTIVE SYSTEM & RELATED PROCEDURES

Facility

$6,484.17

Service Code	APR-DRG 4842
Min. Negotiated Rate	$3,840.89
Max. Negotiated Rate	$6,484.17
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,840.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,840.89
Rate for Payer: Managed Health Services Medicaid	$3,840.89
Rate for Payer: MDWise Medicaid	$3,840.89

APR-DRG 36.00: OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$5,814.19

Service Code	APR-DRG 3512
Min. Negotiated Rate	$3,198.86
Max. Negotiated Rate	$5,814.19
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,814.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,814.19
Rate for Payer: Managed Health Services Medicaid	$5,814.19
Rate for Payer: MDWise Medicaid	$5,814.19

APR-DRG 36.00: OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$5,814.19

Service Code	APR-DRG 3511
Min. Negotiated Rate	$2,550.44
Max. Negotiated Rate	$5,814.19
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,814.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,814.19
Rate for Payer: Managed Health Services Medicaid	$5,814.19
Rate for Payer: MDWise Medicaid	$5,814.19

APR-DRG 36.00: OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$5,814.19

Service Code	APR-DRG 3513
Min. Negotiated Rate	$4,711.83
Max. Negotiated Rate	$5,814.19
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,814.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,814.19
Rate for Payer: Managed Health Services Medicaid	$5,814.19
Rate for Payer: MDWise Medicaid	$5,814.19

Know your out-of-pocket cost for care.

All Charges