Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: OTHER PNEUMONIA

Facility

$2,074.93

Service Code	APR-DRG 1391
Min. Negotiated Rate	$1,726.64
Max. Negotiated Rate	$2,074.93
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,726.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,726.64
Rate for Payer: Managed Health Services Medicaid	$1,726.64
Rate for Payer: MDWise Medicaid	$1,726.64

APR-DRG 36.00: OTHER PNEUMONIA

Facility

$7,046.13

Service Code	APR-DRG 1394
Min. Negotiated Rate	$6,659.89
Max. Negotiated Rate	$7,046.13
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,659.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,659.89
Rate for Payer: Managed Health Services Medicaid	$6,659.89
Rate for Payer: MDWise Medicaid	$6,659.89

APR-DRG 36.00: OTHER PNEUMONIA

Facility

$4,322.78

Service Code	APR-DRG 1393
Min. Negotiated Rate	$3,699.94
Max. Negotiated Rate	$4,322.78
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,699.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,699.94
Rate for Payer: Managed Health Services Medicaid	$3,699.94
Rate for Payer: MDWise Medicaid	$3,699.94

APR-DRG 36.00: OTHER PNEUMONIA

Facility

$2,853.03

Service Code	APR-DRG 1392
Min. Negotiated Rate	$2,466.62
Max. Negotiated Rate	$2,853.03
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 PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility

$5,706.07

Service Code	APR-DRG 4051
Min. Negotiated Rate	$4,369.45
Max. Negotiated Rate	$5,706.07
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,369.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,369.45
Rate for Payer: Managed Health Services Medicaid	$4,369.45
Rate for Payer: MDWise Medicaid	$4,369.45

APR-DRG 36.00: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility

$19,711.88

Service Code	APR-DRG 4054
Min. Negotiated Rate	$16,702.58
Max. Negotiated Rate	$19,711.88
Rate for Payer: Anthem Blue Cross of IN Medicaid	$16,702.58
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$16,702.58
Rate for Payer: Managed Health Services Medicaid	$16,702.58
Rate for Payer: MDWise Medicaid	$16,702.58

APR-DRG 36.00: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility

$6,916.45

Service Code	APR-DRG 4052
Min. Negotiated Rate	$5,038.96
Max. Negotiated Rate	$6,916.45
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,038.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,038.96
Rate for Payer: Managed Health Services Medicaid	$5,038.96
Rate for Payer: MDWise Medicaid	$5,038.96

APR-DRG 36.00: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility

$10,331.44

Service Code	APR-DRG 4053
Min. Negotiated Rate	$7,505.59
Max. Negotiated Rate	$10,331.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,505.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,505.59
Rate for Payer: Managed Health Services Medicaid	$7,505.59
Rate for Payer: MDWise Medicaid	$7,505.59

APR-DRG 36.00: OTHER PROCEDURES OF BLOOD & BLOODFORMING ORGANS

Facility

$10,634.04

Service Code	APR-DRG 6513
Min. Negotiated Rate	$6,589.41
Max. Negotiated Rate	$10,634.04
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 PROCEDURES OF BLOOD & BLOODFORMING ORGANS

Facility

$20,533.21

Service Code	APR-DRG 6514
Min. Negotiated Rate	$7,294.16
Max. Negotiated Rate	$20,533.21
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,294.16
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,294.16
Rate for Payer: Managed Health Services Medicaid	$7,294.16
Rate for Payer: MDWise Medicaid	$7,294.16

APR-DRG 36.00: OTHER PROCEDURES OF BLOOD & BLOODFORMING ORGANS

Facility

$7,824.23

Service Code	APR-DRG 6512
Min. Negotiated Rate	$4,968.49
Max. Negotiated Rate	$7,824.23
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,968.49
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,968.49
Rate for Payer: Managed Health Services Medicaid	$4,968.49
Rate for Payer: MDWise Medicaid	$4,968.49

APR-DRG 36.00: OTHER PROCEDURES OF BLOOD & BLOODFORMING ORGANS

Facility

$5,533.16

Service Code	APR-DRG 6511
Min. Negotiated Rate	$4,439.93
Max. Negotiated Rate	$5,533.16
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,439.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,439.93
Rate for Payer: Managed Health Services Medicaid	$4,439.93
Rate for Payer: MDWise Medicaid	$4,439.93

APR-DRG 36.00: OTHER RESPIRATORY & CHEST PROCEDURES

Facility

$8,213.28

Service Code	APR-DRG 1212
Min. Negotiated Rate	$6,836.07
Max. Negotiated Rate	$8,213.28
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,836.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,836.07
Rate for Payer: Managed Health Services Medicaid	$6,836.07
Rate for Payer: MDWise Medicaid	$6,836.07

APR-DRG 36.00: OTHER RESPIRATORY & CHEST PROCEDURES

Facility

$20,057.70

Service Code	APR-DRG 1214
Min. Negotiated Rate	$20,050.14
Max. Negotiated Rate	$20,057.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$20,050.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$20,050.14
Rate for Payer: Managed Health Services Medicaid	$20,050.14
Rate for Payer: MDWise Medicaid	$20,050.14

APR-DRG 36.00: OTHER RESPIRATORY & CHEST PROCEDURES

Facility

$12,708.97

Service Code	APR-DRG 1213
Min. Negotiated Rate	$10,183.64
Max. Negotiated Rate	$12,708.97
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 RESPIRATORY & CHEST PROCEDURES

Facility

$6,268.03

Service Code	APR-DRG 1211
Min. Negotiated Rate	$6,096.09
Max. Negotiated Rate	$6,268.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,096.09
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,096.09
Rate for Payer: Managed Health Services Medicaid	$6,096.09
Rate for Payer: MDWise Medicaid	$6,096.09

APR-DRG 36.00: OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES

Facility

$3,594.22

Service Code	APR-DRG 1432
Min. Negotiated Rate	$3,501.45
Max. Negotiated Rate	$3,594.22
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,594.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,594.22
Rate for Payer: Managed Health Services Medicaid	$3,594.22
Rate for Payer: MDWise Medicaid	$3,594.22

APR-DRG 36.00: OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES

Facility

$2,924.71

Service Code	APR-DRG 1431
Min. Negotiated Rate	$2,463.98
Max. Negotiated Rate	$2,924.71
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,924.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,924.71
Rate for Payer: Managed Health Services Medicaid	$2,924.71
Rate for Payer: MDWise Medicaid	$2,924.71

APR-DRG 36.00: OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES

Facility

$5,403.48

Service Code	APR-DRG 1433
Min. Negotiated Rate	$4,404.69
Max. Negotiated Rate	$5,403.48
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,404.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,404.69
Rate for Payer: Managed Health Services Medicaid	$4,404.69
Rate for Payer: MDWise Medicaid	$4,404.69

APR-DRG 36.00: OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DIAGNOSES

Facility

$8,948.15

Service Code	APR-DRG 1434
Min. Negotiated Rate	$8,457.00
Max. Negotiated Rate	$8,948.15
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,457.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,457.00
Rate for Payer: Managed Health Services Medicaid	$8,457.00
Rate for Payer: MDWise Medicaid	$8,457.00

APR-DRG 36.00: OTHER SIGNIFICANT HIP & FEMUR SURGERY

Facility

$11,887.65

Service Code	APR-DRG 3093
Min. Negotiated Rate	$8,421.76
Max. Negotiated Rate	$11,887.65
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,421.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,421.76
Rate for Payer: Managed Health Services Medicaid	$8,421.76
Rate for Payer: MDWise Medicaid	$8,421.76

APR-DRG 36.00: OTHER SIGNIFICANT HIP & FEMUR SURGERY

Facility

$17,074.98

Service Code	APR-DRG 3094
Min. Negotiated Rate	$13,425.49
Max. Negotiated Rate	$17,074.98
Rate for Payer: Anthem Blue Cross of IN Medicaid	$13,425.49
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$13,425.49
Rate for Payer: Managed Health Services Medicaid	$13,425.49
Rate for Payer: MDWise Medicaid	$13,425.49

APR-DRG 36.00: OTHER SIGNIFICANT HIP & FEMUR SURGERY

Facility

$6,657.08

Service Code	APR-DRG 3091
Min. Negotiated Rate	$5,038.96
Max. Negotiated Rate	$6,657.08
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,038.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,038.96
Rate for Payer: Managed Health Services Medicaid	$5,038.96
Rate for Payer: MDWise Medicaid	$5,038.96

APR-DRG 36.00: OTHER SIGNIFICANT HIP & FEMUR SURGERY

Facility

$8,732.02

Service Code	APR-DRG 3092
Min. Negotiated Rate	$7,329.40
Max. Negotiated Rate	$8,732.02
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,329.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,329.40
Rate for Payer: Managed Health Services Medicaid	$7,329.40
Rate for Payer: MDWise Medicaid	$7,329.40

APR-DRG 36.00: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility

$2,334.30

Service Code	APR-DRG 3851
Min. Negotiated Rate	$2,219.96
Max. Negotiated Rate	$2,334.30
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,219.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,219.96
Rate for Payer: Managed Health Services Medicaid	$2,219.96
Rate for Payer: MDWise Medicaid	$2,219.96

Know your out-of-pocket cost for care.

All Charges