Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$4,927.97

Service Code	APR-DRG 3853
Min. Negotiated Rate	$3,065.66
Max. Negotiated Rate	$4,927.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,065.66
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,065.66
Rate for Payer: Managed Health Services Medicaid	$3,065.66
Rate for Payer: MDWise Medicaid	$3,065.66

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

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

Facility

$3,065.66

Service Code	APR-DRG 3852
Min. Negotiated Rate	$3,025.95
Max. Negotiated Rate	$3,065.66
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,065.66
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,065.66
Rate for Payer: Managed Health Services Medicaid	$3,065.66
Rate for Payer: MDWise Medicaid	$3,065.66

APR-DRG 36.00: OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES

Facility

$3,631.14

Service Code	APR-DRG 3641
Min. Negotiated Rate	$3,206.61
Max. Negotiated Rate	$3,631.14
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 SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES

Facility

$4,798.29

Service Code	APR-DRG 3642
Min. Negotiated Rate	$4,757.06
Max. Negotiated Rate	$4,798.29
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,757.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,757.06
Rate for Payer: Managed Health Services Medicaid	$4,757.06
Rate for Payer: MDWise Medicaid	$4,757.06

APR-DRG 36.00: OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES

Facility

$7,910.69

Service Code	APR-DRG 3643
Min. Negotiated Rate	$6,730.36
Max. Negotiated Rate	$7,910.69
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,730.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,730.36
Rate for Payer: Managed Health Services Medicaid	$6,730.36
Rate for Payer: MDWise Medicaid	$6,730.36

APR-DRG 36.00: OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES

Facility

$13,314.16

Service Code	APR-DRG 3644
Min. Negotiated Rate	$10,218.88
Max. Negotiated Rate	$13,314.16
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,218.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,218.88
Rate for Payer: Managed Health Services Medicaid	$10,218.88
Rate for Payer: MDWise Medicaid	$10,218.88

APR-DRG 36.00: OTHER SMALL & LARGE BOWEL PROCEDURES

Facility

$5,187.34

Service Code	APR-DRG 2231
Min. Negotiated Rate	$4,933.25
Max. Negotiated Rate	$5,187.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,933.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,933.25
Rate for Payer: Managed Health Services Medicaid	$4,933.25
Rate for Payer: MDWise Medicaid	$4,933.25

APR-DRG 36.00: OTHER SMALL & LARGE BOWEL PROCEDURES

Facility

$6,613.85

Service Code	APR-DRG 2232
Min. Negotiated Rate	$6,201.80
Max. Negotiated Rate	$6,613.85
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,201.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,201.80
Rate for Payer: Managed Health Services Medicaid	$6,201.80
Rate for Payer: MDWise Medicaid	$6,201.80

APR-DRG 36.00: OTHER SMALL & LARGE BOWEL PROCEDURES

Facility

$16,685.93

Service Code	APR-DRG 2234
Min. Negotiated Rate	$10,888.39
Max. Negotiated Rate	$16,685.93
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,888.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,888.39
Rate for Payer: Managed Health Services Medicaid	$10,888.39
Rate for Payer: MDWise Medicaid	$10,888.39

APR-DRG 36.00: OTHER SMALL & LARGE BOWEL PROCEDURES

Facility

$9,293.98

Service Code	APR-DRG 2233
Min. Negotiated Rate	$6,483.70
Max. Negotiated Rate	$9,293.98
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,483.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,483.70
Rate for Payer: Managed Health Services Medicaid	$6,483.70
Rate for Payer: MDWise Medicaid	$6,483.70

APR-DRG 36.00: OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$6,440.94

Service Code	APR-DRG 2222
Min. Negotiated Rate	$4,898.01
Max. Negotiated Rate	$6,440.94
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,898.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,898.01
Rate for Payer: Managed Health Services Medicaid	$4,898.01
Rate for Payer: MDWise Medicaid	$4,898.01

APR-DRG 36.00: OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$17,464.03

Service Code	APR-DRG 2224
Min. Negotiated Rate	$11,522.66
Max. Negotiated Rate	$17,464.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,522.66
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,522.66
Rate for Payer: Managed Health Services Medicaid	$11,522.66
Rate for Payer: MDWise Medicaid	$11,522.66

APR-DRG 36.00: OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$3,674.36

Service Code	APR-DRG 2221
Min. Negotiated Rate	$1,902.83
Max. Negotiated Rate	$3,674.36
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,902.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,902.83
Rate for Payer: Managed Health Services Medicaid	$1,902.83
Rate for Payer: MDWise Medicaid	$1,902.83

APR-DRG 36.00: OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility

$10,288.22

Service Code	APR-DRG 2223
Min. Negotiated Rate	$7,294.16
Max. Negotiated Rate	$10,288.22
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 & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE

Facility

$5,144.11

Service Code	APR-DRG 2533
Min. Negotiated Rate	$4,122.79
Max. Negotiated Rate	$5,144.11
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,122.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,122.79
Rate for Payer: Managed Health Services Medicaid	$4,122.79
Rate for Payer: MDWise Medicaid	$4,122.79

APR-DRG 36.00: OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE

Facility

$3,415.00

Service Code	APR-DRG 2532
Min. Negotiated Rate	$2,854.24
Max. Negotiated Rate	$3,415.00
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,854.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,854.24
Rate for Payer: Managed Health Services Medicaid	$2,854.24
Rate for Payer: MDWise Medicaid	$2,854.24

APR-DRG 36.00: OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE

Facility

$8,861.70

Service Code	APR-DRG 2534
Min. Negotiated Rate	$7,223.69
Max. Negotiated Rate	$8,861.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,223.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,223.69
Rate for Payer: Managed Health Services Medicaid	$7,223.69
Rate for Payer: MDWise Medicaid	$7,223.69

APR-DRG 36.00: OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE

Facility

$2,636.90

Service Code	APR-DRG 2531
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$2,636.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,501.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,501.86
Rate for Payer: Managed Health Services Medicaid	$2,501.86
Rate for Payer: MDWise Medicaid	$2,501.86

APR-DRG 36.00: OVERDOSE

Facility

$1,867.59

Service Code	APR-DRG 8171
Min. Negotiated Rate	$1,772.34
Max. Negotiated Rate	$1,867.59
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,867.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,867.59
Rate for Payer: Managed Health Services Medicaid	$1,867.59
Rate for Payer: MDWise Medicaid	$1,867.59

APR-DRG 36.00: OVERDOSE

Facility

$2,593.67

Service Code	APR-DRG 8172
Min. Negotiated Rate	$2,290.44
Max. Negotiated Rate	$2,593.67
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,290.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,290.44
Rate for Payer: Managed Health Services Medicaid	$2,290.44
Rate for Payer: MDWise Medicaid	$2,290.44

APR-DRG 36.00: OVERDOSE

Facility

$4,884.74

Service Code	APR-DRG 8173
Min. Negotiated Rate	$2,642.81
Max. Negotiated Rate	$4,884.74
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,642.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,642.81
Rate for Payer: Managed Health Services Medicaid	$2,642.81
Rate for Payer: MDWise Medicaid	$2,642.81

APR-DRG 36.00: OVERDOSE

Facility

$9,942.39

Service Code	APR-DRG 8174
Min. Negotiated Rate	$6,025.61
Max. Negotiated Rate	$9,942.39
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,025.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,025.61
Rate for Payer: Managed Health Services Medicaid	$6,025.61
Rate for Payer: MDWise Medicaid	$6,025.61

APR-DRG 36.00: PANCREAS TRANSPLANT

Facility

$49,711.97

Service Code	APR-DRG 0064
Min. Negotiated Rate	$46,231.60
Max. Negotiated Rate	$49,711.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$46,231.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$46,231.60
Rate for Payer: Managed Health Services Medicaid	$46,231.60
Rate for Payer: MDWise Medicaid	$46,231.60

APR-DRG 36.00: PANCREAS TRANSPLANT

Facility

$38,299.83

Service Code	APR-DRG 0063
Min. Negotiated Rate	$31,713.75
Max. Negotiated Rate	$38,299.83
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

Know your out-of-pocket cost for care.

All Charges