Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 36.00: TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES

Facility

$6,268.03

Service Code	APR-DRG 3172
Min. Negotiated Rate	$5,497.05
Max. Negotiated Rate	$6,268.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,497.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,497.05
Rate for Payer: Managed Health Services Medicaid	$5,497.05
Rate for Payer: MDWise Medicaid	$5,497.05

APR-DRG 36.00: TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES

Facility

$8,948.15

Service Code	APR-DRG 3173
Min. Negotiated Rate	$7,681.77
Max. Negotiated Rate	$8,948.15
Rate for Payer: Anthem Blue Cross of IN Medicaid	$7,681.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$7,681.77
Rate for Payer: Managed Health Services Medicaid	$7,681.77
Rate for Payer: MDWise Medicaid	$7,681.77

APR-DRG 36.00: TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES

Facility

$4,711.83

Service Code	APR-DRG 3171
Min. Negotiated Rate	$3,312.32
Max. Negotiated Rate	$4,711.83
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: TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES

Facility

$17,090.19

Service Code	APR-DRG 3174
Min. Negotiated Rate	$15,259.41
Max. Negotiated Rate	$17,090.19
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,090.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,090.19
Rate for Payer: Managed Health Services Medicaid	$17,090.19
Rate for Payer: MDWise Medicaid	$17,090.19

APR-DRG 36.00: THYROID DISORDERS

Facility

$9,423.66

Service Code	APR-DRG 4274
Min. Negotiated Rate	$3,735.18
Max. Negotiated Rate	$9,423.66
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,735.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,735.18
Rate for Payer: Managed Health Services Medicaid	$3,735.18
Rate for Payer: MDWise Medicaid	$3,735.18

APR-DRG 36.00: THYROID DISORDERS

Facility

$3,198.86

Service Code	APR-DRG 4272
Min. Negotiated Rate	$2,889.47
Max. Negotiated Rate	$3,198.86
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,889.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,889.47
Rate for Payer: Managed Health Services Medicaid	$2,889.47
Rate for Payer: MDWise Medicaid	$2,889.47

APR-DRG 36.00: THYROID DISORDERS

Facility

$2,377.53

Service Code	APR-DRG 4271
Min. Negotiated Rate	$1,550.45
Max. Negotiated Rate	$2,377.53
Rate for Payer: Anthem Blue Cross of IN Medicaid	$1,550.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$1,550.45
Rate for Payer: Managed Health Services Medicaid	$1,550.45
Rate for Payer: MDWise Medicaid	$1,550.45

APR-DRG 36.00: THYROID DISORDERS

Facility

$5,230.56

Service Code	APR-DRG 4273
Min. Negotiated Rate	$3,558.99
Max. Negotiated Rate	$5,230.56
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,558.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,558.99
Rate for Payer: Managed Health Services Medicaid	$3,558.99
Rate for Payer: MDWise Medicaid	$3,558.99

APR-DRG 36.00: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility

$19,495.74

Service Code	APR-DRG 4044
Min. Negotiated Rate	$9,690.31
Max. Negotiated Rate	$19,495.74
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,690.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,690.31
Rate for Payer: Managed Health Services Medicaid	$9,690.31
Rate for Payer: MDWise Medicaid	$9,690.31

APR-DRG 36.00: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility

$6,829.99

Service Code	APR-DRG 4042
Min. Negotiated Rate	$4,898.01
Max. Negotiated Rate	$6,829.99
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: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility

$11,282.46

Service Code	APR-DRG 4043
Min. Negotiated Rate	$7,399.88
Max. Negotiated Rate	$11,282.46
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: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility

$4,841.51

Service Code	APR-DRG 4041
Min. Negotiated Rate	$3,277.09
Max. Negotiated Rate	$4,841.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,277.09
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,277.09
Rate for Payer: Managed Health Services Medicaid	$3,277.09
Rate for Payer: MDWise Medicaid	$3,277.09

APR-DRG 36.00: TONSIL & ADENOID PROCEDURES

Facility

$2,853.03

Service Code	APR-DRG 0971
Min. Negotiated Rate	$2,325.68
Max. Negotiated Rate	$2,853.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,325.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,325.68
Rate for Payer: Managed Health Services Medicaid	$2,325.68
Rate for Payer: MDWise Medicaid	$2,325.68

APR-DRG 36.00: TONSIL & ADENOID PROCEDURES

Facility

$11,412.14

Service Code	APR-DRG 0974
Min. Negotiated Rate	$5,003.73
Max. Negotiated Rate	$11,412.14
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,003.73
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,003.73
Rate for Payer: Managed Health Services Medicaid	$5,003.73
Rate for Payer: MDWise Medicaid	$5,003.73

APR-DRG 36.00: TONSIL & ADENOID PROCEDURES

Facility

$4,452.46

Service Code	APR-DRG 0972
Min. Negotiated Rate	$3,241.85
Max. Negotiated Rate	$4,452.46
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,241.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,241.85
Rate for Payer: Managed Health Services Medicaid	$3,241.85
Rate for Payer: MDWise Medicaid	$3,241.85

APR-DRG 36.00: TONSIL & ADENOID PROCEDURES

Facility

$7,046.13

Service Code	APR-DRG 0973
Min. Negotiated Rate	$3,981.84
Max. Negotiated Rate	$7,046.13
Rate for Payer: Anthem Blue Cross of IN Medicaid	$3,981.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$3,981.84
Rate for Payer: Managed Health Services Medicaid	$3,981.84
Rate for Payer: MDWise Medicaid	$3,981.84

APR-DRG 36.00: TOXIC EFFECTS OF NONMEDICINAL SUBSTANCES

Facility

$5,489.93

Service Code	APR-DRG 8163
Min. Negotiated Rate	$2,854.24
Max. Negotiated Rate	$5,489.93
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: TOXIC EFFECTS OF NONMEDICINAL SUBSTANCES

Facility

$10,504.36

Service Code	APR-DRG 8164
Min. Negotiated Rate	$6,307.51
Max. Negotiated Rate	$10,504.36
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,307.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,307.51
Rate for Payer: Managed Health Services Medicaid	$6,307.51
Rate for Payer: MDWise Medicaid	$6,307.51

APR-DRG 36.00: TOXIC EFFECTS OF NONMEDICINAL SUBSTANCES

Facility

$2,118.16

Service Code	APR-DRG 8161
Min. Negotiated Rate	$1,902.83
Max. Negotiated Rate	$2,118.16
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: TOXIC EFFECTS OF NONMEDICINAL SUBSTANCES

Facility

$2,896.26

Service Code	APR-DRG 8162
Min. Negotiated Rate	$2,431.39
Max. Negotiated Rate	$2,896.26
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: TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE

Facility

$33,847.37

Service Code	APR-DRG 0042
Min. Negotiated Rate	$32,101.36
Max. Negotiated Rate	$33,847.37
Rate for Payer: Anthem Blue Cross of IN Medicaid	$32,101.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$32,101.36
Rate for Payer: Managed Health Services Medicaid	$32,101.36
Rate for Payer: MDWise Medicaid	$32,101.36

APR-DRG 36.00: TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE

Facility

$52,997.28

Service Code	APR-DRG 0043
Min. Negotiated Rate	$32,101.36
Max. Negotiated Rate	$52,997.28
Rate for Payer: Anthem Blue Cross of IN Medicaid	$32,101.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$32,101.36
Rate for Payer: Managed Health Services Medicaid	$32,101.36
Rate for Payer: MDWise Medicaid	$32,101.36

APR-DRG 36.00: TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE

Facility

$76,859.03

Service Code	APR-DRG 0044
Min. Negotiated Rate	$65,365.56
Max. Negotiated Rate	$76,859.03
Rate for Payer: Anthem Blue Cross of IN Medicaid	$65,365.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$65,365.56
Rate for Payer: Managed Health Services Medicaid	$65,365.56
Rate for Payer: MDWise Medicaid	$65,365.56

APR-DRG 36.00: TRACHEOSTOMY W MV 96+ HOURS W EXTENSIVE PROCEDURE

Facility

$32,101.36

Service Code	APR-DRG 0041
Min. Negotiated Rate	$23,429.47
Max. Negotiated Rate	$32,101.36
Rate for Payer: Anthem Blue Cross of IN Medicaid	$32,101.36
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$32,101.36
Rate for Payer: Managed Health Services Medicaid	$32,101.36
Rate for Payer: MDWise Medicaid	$32,101.36

APR-DRG 36.00: TRACHEOSTOMY W MV 96+ HOURS W/O EXTENSIVE PROCEDURE

Facility

$53,516.02

Service Code	APR-DRG 0054
Min. Negotiated Rate	$42,461.19
Max. Negotiated Rate	$53,516.02
Rate for Payer: Anthem Blue Cross of IN Medicaid	$42,461.19
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$42,461.19
Rate for Payer: Managed Health Services Medicaid	$42,461.19
Rate for Payer: MDWise Medicaid	$42,461.19

Know your out-of-pocket cost for care.

All Charges