Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: SEIZURE

Facility

$5,360.25

Service Code	APR-DRG 0533
Min. Negotiated Rate	$3,453.28
Max. Negotiated Rate	$5,360.25
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,453.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,453.28
Rate for Payer: Managed Health Services Medicaid	$3,453.28
Rate for Payer: MDWise Medicaid	$3,453.28

APR-DRG 36.00: SEIZURE

Facility

$2,507.21

Service Code	APR-DRG 0531
Min. Negotiated Rate	$2,079.01
Max. Negotiated Rate	$2,507.21
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,079.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,079.01
Rate for Payer: Managed Health Services Medicaid	$2,079.01
Rate for Payer: MDWise Medicaid	$2,079.01

APR-DRG 36.00: SEPTICEMIA & DISSEMINATED INFECTIONS

Facility

$6,311.26

Service Code	APR-DRG 7203
Min. Negotiated Rate	$4,651.35
Max. Negotiated Rate	$6,311.26
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: SEPTICEMIA & DISSEMINATED INFECTIONS

Facility

$2,853.03

Service Code	APR-DRG 7201
Min. Negotiated Rate	$2,431.39
Max. Negotiated Rate	$2,853.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,431.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,431.39
Rate for Payer: Managed Health Services Medicaid	$2,431.39
Rate for Payer: MDWise Medicaid	$2,431.39

APR-DRG 36.00: SEPTICEMIA & DISSEMINATED INFECTIONS

Facility

$3,976.96

Service Code	APR-DRG 7202
Min. Negotiated Rate	$3,100.90
Max. Negotiated Rate	$3,976.96
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: SEPTICEMIA & DISSEMINATED INFECTIONS

Facility

$11,671.51

Service Code	APR-DRG 7204
Min. Negotiated Rate	$10,676.96
Max. Negotiated Rate	$11,671.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$10,676.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$10,676.96
Rate for Payer: Managed Health Services Medicaid	$10,676.96
Rate for Payer: MDWise Medicaid	$10,676.96

APR-DRG 36.00: SHOULDER & ELBOW JOINT REPLACEMENT

Facility

$8,738.90

Service Code	APR-DRG 3222
Min. Negotiated Rate	$8,342.97
Max. Negotiated Rate	$8,738.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,738.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,738.90
Rate for Payer: Managed Health Services Medicaid	$8,738.90
Rate for Payer: MDWise Medicaid	$8,738.90

APR-DRG 36.00: SHOULDER & ELBOW JOINT REPLACEMENT

Facility

$11,368.91

Service Code	APR-DRG 3223
Min. Negotiated Rate	$8,738.90
Max. Negotiated Rate	$11,368.91
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,738.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,738.90
Rate for Payer: Managed Health Services Medicaid	$8,738.90
Rate for Payer: MDWise Medicaid	$8,738.90

APR-DRG 36.00: SHOULDER & ELBOW JOINT REPLACEMENT

Facility

$8,738.90

Service Code	APR-DRG 3221
Min. Negotiated Rate	$6,873.22
Max. Negotiated Rate	$8,738.90
Rate for Payer: Anthem Blue Cross of IN Medicaid	$8,738.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$8,738.90
Rate for Payer: Managed Health Services Medicaid	$8,738.90
Rate for Payer: MDWise Medicaid	$8,738.90

APR-DRG 36.00: SHOULDER & ELBOW JOINT REPLACEMENT

Facility

$14,567.77

Service Code	APR-DRG 3224
Min. Negotiated Rate	$9,866.50
Max. Negotiated Rate	$14,567.77
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,866.50
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,866.50
Rate for Payer: Managed Health Services Medicaid	$9,866.50
Rate for Payer: MDWise Medicaid	$9,866.50

APR-DRG 36.00: SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$10,763.72

Service Code	APR-DRG 3153
Min. Negotiated Rate	$9,337.94
Max. Negotiated Rate	$10,763.72
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,337.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,337.94
Rate for Payer: Managed Health Services Medicaid	$9,337.94
Rate for Payer: MDWise Medicaid	$9,337.94

APR-DRG 36.00: SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$16,815.61

Service Code	APR-DRG 3154
Min. Negotiated Rate	$11,029.34
Max. Negotiated Rate	$16,815.61
Rate for Payer: Anthem Blue Cross of IN Medicaid	$11,029.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$11,029.34
Rate for Payer: Managed Health Services Medicaid	$11,029.34
Rate for Payer: MDWise Medicaid	$11,029.34

APR-DRG 36.00: SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$5,446.70

Service Code	APR-DRG 3151
Min. Negotiated Rate	$4,721.82
Max. Negotiated Rate	$5,446.70
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,721.82
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,721.82
Rate for Payer: Managed Health Services Medicaid	$4,721.82
Rate for Payer: MDWise Medicaid	$4,721.82

APR-DRG 36.00: SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$7,953.92

Service Code	APR-DRG 3152
Min. Negotiated Rate	$5,109.44
Max. Negotiated Rate	$7,953.92
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,109.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,109.44
Rate for Payer: Managed Health Services Medicaid	$5,109.44
Rate for Payer: MDWise Medicaid	$5,109.44

APR-DRG 36.00: SICKLE CELL ANEMIA CRISIS

Facility

$3,631.14

Service Code	APR-DRG 6622
Min. Negotiated Rate	$3,594.22
Max. Negotiated Rate	$3,631.14
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: SICKLE CELL ANEMIA CRISIS

Facility

$5,792.53

Service Code	APR-DRG 6623
Min. Negotiated Rate	$5,708.48
Max. Negotiated Rate	$5,792.53
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,708.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,708.48
Rate for Payer: Managed Health Services Medicaid	$5,708.48
Rate for Payer: MDWise Medicaid	$5,708.48

APR-DRG 36.00: SICKLE CELL ANEMIA CRISIS

Facility

$2,924.71

Service Code	APR-DRG 6621
Min. Negotiated Rate	$2,636.90
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: SICKLE CELL ANEMIA CRISIS

Facility

$10,504.36

Service Code	APR-DRG 6624
Min. Negotiated Rate	$7,399.88
Max. Negotiated Rate	$10,504.36
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,399.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,399.88
Rate for Payer: Managed Health Services Medicaid	$7,399.88
Rate for Payer: MDWise Medicaid	$7,399.88

APR-DRG 36.00: SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$7,219.04

Service Code	APR-DRG 8614
Min. Negotiated Rate	$5,109.44
Max. Negotiated Rate	$7,219.04
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,109.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,109.44
Rate for Payer: Managed Health Services Medicaid	$5,109.44
Rate for Payer: MDWise Medicaid	$5,109.44

APR-DRG 36.00: SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$3,312.32

Service Code	APR-DRG 8612
Min. Negotiated Rate	$3,025.95
Max. Negotiated Rate	$3,312.32
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: SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$5,109.44

Service Code	APR-DRG 8613
Min. Negotiated Rate	$4,409.24
Max. Negotiated Rate	$5,109.44
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,109.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,109.44
Rate for Payer: Managed Health Services Medicaid	$5,109.44
Rate for Payer: MDWise Medicaid	$5,109.44

APR-DRG 36.00: SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$2,678.05

Service Code	APR-DRG 8611
Min. Negotiated Rate	$2,291.07
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: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES

Facility

$6,657.08

Service Code	APR-DRG 3121
Min. Negotiated Rate	$4,721.82
Max. Negotiated Rate	$6,657.08
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,721.82
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,721.82
Rate for Payer: Managed Health Services Medicaid	$4,721.82
Rate for Payer: MDWise Medicaid	$4,721.82

APR-DRG 36.00: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES

Facility

$24,701.49

Service Code	APR-DRG 3124
Min. Negotiated Rate	$23,861.75
Max. Negotiated Rate	$24,701.49
Rate for Payer: Anthem Blue Cross of IN Medicaid	$24,701.49
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$24,701.49
Rate for Payer: Managed Health Services Medicaid	$24,701.49
Rate for Payer: MDWise Medicaid	$24,701.49

APR-DRG 36.00: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES

Facility

$9,553.34

Service Code	APR-DRG 3122
Min. Negotiated Rate	$4,721.82
Max. Negotiated Rate	$9,553.34
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,721.82
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,721.82
Rate for Payer: Managed Health Services Medicaid	$4,721.82
Rate for Payer: MDWise Medicaid	$4,721.82

Know your out-of-pocket cost for care.

All Charges