Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

APR-DRG 36.00: PANCREAS TRANSPLANT

Facility

$31,713.75

Service Code	APR-DRG 0061
Min. Negotiated Rate	$22,953.96
Max. Negotiated Rate	$31,713.75
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

APR-DRG 36.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY & OTHER RADICAL GYN PROCS

Facility

$5,250.39

Service Code	APR-DRG 5102
Min. Negotiated Rate	$5,250.39
Max. Negotiated Rate	$5,250.39
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: PELVIC EVISCERATION, RADICAL HYSTERECTOMY & OTHER RADICAL GYN PROCS

Facility

$5,250.39

Service Code	APR-DRG 5104
Min. Negotiated Rate	$5,250.39
Max. Negotiated Rate	$5,250.39
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: PELVIC EVISCERATION, RADICAL HYSTERECTOMY & OTHER RADICAL GYN PROCS

Facility

$5,250.39

Service Code	APR-DRG 5103
Min. Negotiated Rate	$5,250.39
Max. Negotiated Rate	$5,250.39
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: PELVIC EVISCERATION, RADICAL HYSTERECTOMY & OTHER RADICAL GYN PROCS

Facility

$4,686.59

Service Code	APR-DRG 5101
Min. Negotiated Rate	$4,686.59
Max. Negotiated Rate	$4,686.59
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,686.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,686.59
Rate for Payer: Managed Health Services Medicaid	$4,686.59
Rate for Payer: MDWise Medicaid	$4,686.59

APR-DRG 36.00: PENIS, TESTES & SCROTAL PROCEDURES

Facility

$6,527.40

Service Code	APR-DRG 4832
Min. Negotiated Rate	$4,475.16
Max. Negotiated Rate	$6,527.40
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,475.16
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,475.16
Rate for Payer: Managed Health Services Medicaid	$4,475.16
Rate for Payer: MDWise Medicaid	$4,475.16

APR-DRG 36.00: PENIS, TESTES & SCROTAL PROCEDURES

Facility

$17,247.89

Service Code	APR-DRG 4834
Min. Negotiated Rate	$7,717.01
Max. Negotiated Rate	$17,247.89
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,717.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,717.01
Rate for Payer: Managed Health Services Medicaid	$7,717.01
Rate for Payer: MDWise Medicaid	$7,717.01

APR-DRG 36.00: PENIS, TESTES & SCROTAL PROCEDURES

Facility

$9,855.94

Service Code	APR-DRG 4833
Min. Negotiated Rate	$5,955.14
Max. Negotiated Rate	$9,855.94
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,955.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,955.14
Rate for Payer: Managed Health Services Medicaid	$5,955.14
Rate for Payer: MDWise Medicaid	$5,955.14

APR-DRG 36.00: PENIS, TESTES & SCROTAL PROCEDURES

Facility

$4,279.55

Service Code	APR-DRG 4831
Min. Negotiated Rate	$3,876.12
Max. Negotiated Rate	$4,279.55
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: PEPTIC ULCER & GASTRITIS

Facility

$5,446.70

Service Code	APR-DRG 2413
Min. Negotiated Rate	$4,545.64
Max. Negotiated Rate	$5,446.70
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: PEPTIC ULCER & GASTRITIS

Facility

$3,025.95

Service Code	APR-DRG 2411
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$3,025.95
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: PEPTIC ULCER & GASTRITIS

Facility

$3,674.36

Service Code	APR-DRG 2412
Min. Negotiated Rate	$2,924.71
Max. Negotiated Rate	$3,674.36
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: PEPTIC ULCER & GASTRITIS

Facility

$10,331.44

Service Code	APR-DRG 2414
Min. Negotiated Rate	$8,562.71
Max. Negotiated Rate	$10,331.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,562.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,562.71
Rate for Payer: Managed Health Services Medicaid	$8,562.71
Rate for Payer: MDWise Medicaid	$8,562.71

APR-DRG 36.00: PERCUTANEOUS CORONARY INTERVENTION W AMI

Facility

$16,599.48

Service Code	APR-DRG 1744
Min. Negotiated Rate	$15,011.17
Max. Negotiated Rate	$16,599.48
Rate for Payer: Anthem Blue Cross of IN Medicaid	$15,011.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$15,011.17
Rate for Payer: Managed Health Services Medicaid	$15,011.17
Rate for Payer: MDWise Medicaid	$15,011.17

APR-DRG 36.00: PERCUTANEOUS CORONARY INTERVENTION W AMI

Facility

$9,942.39

Service Code	APR-DRG 1742
Min. Negotiated Rate	$6,659.89
Max. Negotiated Rate	$9,942.39
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: PERCUTANEOUS CORONARY INTERVENTION W AMI

Facility

$7,867.46

Service Code	APR-DRG 1741
Min. Negotiated Rate	$6,237.04
Max. Negotiated Rate	$7,867.46
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,237.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,237.04
Rate for Payer: Managed Health Services Medicaid	$6,237.04
Rate for Payer: MDWise Medicaid	$6,237.04

APR-DRG 36.00: PERCUTANEOUS CORONARY INTERVENTION W AMI

Facility

$11,714.73

Service Code	APR-DRG 1743
Min. Negotiated Rate	$8,386.52
Max. Negotiated Rate	$11,714.73
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: PERCUTANEOUS CORONARY INTERVENTION W/O AMI

Facility

$18,674.41

Service Code	APR-DRG 1754
Min. Negotiated Rate	$18,288.26
Max. Negotiated Rate	$18,674.41
Rate for Payer: Anthem Blue Cross of IN Medicaid	$18,288.26
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$18,288.26
Rate for Payer: Managed Health Services Medicaid	$18,288.26
Rate for Payer: MDWise Medicaid	$18,288.26

APR-DRG 36.00: PERCUTANEOUS CORONARY INTERVENTION W/O AMI

Facility

$11,887.65

Service Code	APR-DRG 1752
Min. Negotiated Rate	$7,822.73
Max. Negotiated Rate	$11,887.65
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,822.73
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,822.73
Rate for Payer: Managed Health Services Medicaid	$7,822.73
Rate for Payer: MDWise Medicaid	$7,822.73

APR-DRG 36.00: PERCUTANEOUS CORONARY INTERVENTION W/O AMI

Facility

$8,991.38

Service Code	APR-DRG 1751
Min. Negotiated Rate	$6,730.36
Max. Negotiated Rate	$8,991.38
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: PERCUTANEOUS CORONARY INTERVENTION W/O AMI

Facility

$13,616.76

Service Code	APR-DRG 1753
Min. Negotiated Rate	$9,196.99
Max. Negotiated Rate	$13,616.76
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,196.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,196.99
Rate for Payer: Managed Health Services Medicaid	$9,196.99
Rate for Payer: MDWise Medicaid	$9,196.99

APR-DRG 36.00: PERIPHERAL, CRANIAL & AUTONOMIC NERVE DISORDERS

Facility

$3,112.40

Service Code	APR-DRG 0481
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$3,112.40
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,678.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,678.05
Rate for Payer: Managed Health Services Medicaid	$2,678.05
Rate for Payer: MDWise Medicaid	$2,678.05

APR-DRG 36.00: PERIPHERAL, CRANIAL & AUTONOMIC NERVE DISORDERS

Facility

$3,804.05

Service Code	APR-DRG 0482
Min. Negotiated Rate	$3,100.90
Max. Negotiated Rate	$3,804.05
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: PERIPHERAL, CRANIAL & AUTONOMIC NERVE DISORDERS

Facility

$5,446.70

Service Code	APR-DRG 0483
Min. Negotiated Rate	$4,158.02
Max. Negotiated Rate	$5,446.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,158.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,158.02
Rate for Payer: Managed Health Services Medicaid	$4,158.02
Rate for Payer: MDWise Medicaid	$4,158.02

Know your out-of-pocket cost for care.

All Charges