Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: POSTOP, POSTTRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE

Facility

$11,368.91

Service Code	APR-DRG 7113
Min. Negotiated Rate	$10,571.25
Max. Negotiated Rate	$11,368.91
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,571.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,571.25
Rate for Payer: Managed Health Services Medicaid	$10,571.25
Rate for Payer: MDWise Medicaid	$10,571.25

APR-DRG 36.00: POSTOP, POSTTRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE

Facility

$7,046.13

Service Code	APR-DRG 7112
Min. Negotiated Rate	$5,814.19
Max. Negotiated Rate	$7,046.13
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: POSTOP, POSTTRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE

Facility

$19,106.69

Service Code	APR-DRG 7114
Min. Negotiated Rate	$16,949.24
Max. Negotiated Rate	$19,106.69
Rate for Payer: Anthem Blue Cross of IN Medicaid	$16,949.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$16,949.24
Rate for Payer: Managed Health Services Medicaid	$16,949.24
Rate for Payer: MDWise Medicaid	$16,949.24

APR-DRG 36.00: POSTOP, POSTTRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE

Facility

$4,927.97

Service Code	APR-DRG 7111
Min. Negotiated Rate	$4,862.77
Max. Negotiated Rate	$4,927.97
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,862.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,862.77
Rate for Payer: Managed Health Services Medicaid	$4,862.77
Rate for Payer: MDWise Medicaid	$4,862.77

APR-DRG 36.00: POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE

Facility

$3,501.45

Service Code	APR-DRG 5613
Min. Negotiated Rate	$3,312.32
Max. Negotiated Rate	$3,501.45
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,312.32
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,312.32
Rate for Payer: Managed Health Services Medicaid	$3,312.32
Rate for Payer: MDWise Medicaid	$3,312.32

APR-DRG 36.00: POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE

Facility

$7,348.73

Service Code	APR-DRG 5614
Min. Negotiated Rate	$4,651.35
Max. Negotiated Rate	$7,348.73
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,651.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,651.35
Rate for Payer: Managed Health Services Medicaid	$4,651.35
Rate for Payer: MDWise Medicaid	$4,651.35

APR-DRG 36.00: POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE

Facility

$2,184.72

Service Code	APR-DRG 5612
Min. Negotiated Rate	$1,945.25
Max. Negotiated Rate	$2,184.72
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: POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE

Facility

$1,726.64

Service Code	APR-DRG 5611
Min. Negotiated Rate	$1,210.38
Max. Negotiated Rate	$1,726.64
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: PRETERM LABOR

Facility

$2,678.05

Service Code	APR-DRG 5633
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$2,678.05
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: PRETERM LABOR

Facility

$2,678.05

Service Code	APR-DRG 5634
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$2,678.05
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: PRETERM LABOR

Facility

$1,585.69

Service Code	APR-DRG 5631
Min. Negotiated Rate	$1,585.69
Max. Negotiated Rate	$1,585.69
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,585.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,585.69
Rate for Payer: Managed Health Services Medicaid	$1,585.69
Rate for Payer: MDWise Medicaid	$1,585.69

APR-DRG 36.00: PRETERM LABOR

Facility

$2,678.05

Service Code	APR-DRG 5632
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$2,678.05
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: PROCEDURES FOR OBESITY

Facility

$9,769.48

Service Code	APR-DRG 4033
Min. Negotiated Rate	$6,659.89
Max. Negotiated Rate	$9,769.48
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: PROCEDURES FOR OBESITY

Facility

$5,778.95

Service Code	APR-DRG 4031
Min. Negotiated Rate	$4,798.29
Max. Negotiated Rate	$5,778.95
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: PROCEDURES FOR OBESITY

Facility

$6,589.41

Service Code	APR-DRG 4032
Min. Negotiated Rate	$5,922.21
Max. Negotiated Rate	$6,589.41
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: PROCEDURES FOR OBESITY

Facility

$19,409.28

Service Code	APR-DRG 4034
Min. Negotiated Rate	$17,407.33
Max. Negotiated Rate	$19,409.28
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,407.33
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,407.33
Rate for Payer: Managed Health Services Medicaid	$17,407.33
Rate for Payer: MDWise Medicaid	$17,407.33

APR-DRG 36.00: PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE

Facility

$7,047.50

Service Code	APR-DRG 8501
Min. Negotiated Rate	$6,397.71
Max. Negotiated Rate	$7,047.50
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,047.50
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,047.50
Rate for Payer: Managed Health Services Medicaid	$7,047.50
Rate for Payer: MDWise Medicaid	$7,047.50

APR-DRG 36.00: PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE

Facility

$26,628.32

Service Code	APR-DRG 8504
Min. Negotiated Rate	$11,945.51
Max. Negotiated Rate	$26,628.32
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,945.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,945.51
Rate for Payer: Managed Health Services Medicaid	$11,945.51
Rate for Payer: MDWise Medicaid	$11,945.51

APR-DRG 36.00: PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE

Facility

$15,000.05

Service Code	APR-DRG 8503
Min. Negotiated Rate	$9,655.08
Max. Negotiated Rate	$15,000.05
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: PROCEDURE W DIAG OF REHAB, AFTERCARE OR OTH CONTACT W HEALTH SERVICE

Facility

$10,028.85

Service Code	APR-DRG 8502
Min. Negotiated Rate	$8,034.15
Max. Negotiated Rate	$10,028.85
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,034.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,034.15
Rate for Payer: Managed Health Services Medicaid	$8,034.15
Rate for Payer: MDWise Medicaid	$8,034.15

APR-DRG 36.00: PULMONARY EMBOLISM

Facility

$3,136.14

Service Code	APR-DRG 1341
Min. Negotiated Rate	$2,463.98
Max. Negotiated Rate	$3,136.14
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,136.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,136.14
Rate for Payer: Managed Health Services Medicaid	$3,136.14
Rate for Payer: MDWise Medicaid	$3,136.14

APR-DRG 36.00: PULMONARY EMBOLISM

Facility

$8,559.10

Service Code	APR-DRG 1344
Min. Negotiated Rate	$7,822.73
Max. Negotiated Rate	$8,559.10
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: PULMONARY EMBOLISM

Facility

$3,328.54

Service Code	APR-DRG 1342
Min. Negotiated Rate	$3,136.14
Max. Negotiated Rate	$3,328.54
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,136.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,136.14
Rate for Payer: Managed Health Services Medicaid	$3,136.14
Rate for Payer: MDWise Medicaid	$3,136.14

APR-DRG 36.00: PULMONARY EMBOLISM

Facility

$5,273.79

Service Code	APR-DRG 1343
Min. Negotiated Rate	$4,510.40
Max. Negotiated Rate	$5,273.79
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,510.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,510.40
Rate for Payer: Managed Health Services Medicaid	$4,510.40
Rate for Payer: MDWise Medicaid	$4,510.40

APR-DRG 36.00: RADIOTHERAPY

Facility

$14,092.26

Service Code	APR-DRG 6924
Min. Negotiated Rate	$11,839.80
Max. Negotiated Rate	$14,092.26
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,839.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,839.80
Rate for Payer: Managed Health Services Medicaid	$11,839.80
Rate for Payer: MDWise Medicaid	$11,839.80

Know your out-of-pocket cost for care.

All Charges