Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$38,861.79

Service Code	APR-DRG 0053
Min. Negotiated Rate	$26,392.89
Max. Negotiated Rate	$38,861.79
Rate for Payer: Anthem Blue Cross of IN Medicaid	$26,392.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$26,392.89
Rate for Payer: Managed Health Services Medicaid	$26,392.89
Rate for Payer: MDWise Medicaid	$26,392.89

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

Facility

$25,893.45

Service Code	APR-DRG 0052
Min. Negotiated Rate	$17,301.61
Max. Negotiated Rate	$25,893.45
Rate for Payer: Anthem Blue Cross of IN Medicaid	$17,301.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$17,301.61
Rate for Payer: Managed Health Services Medicaid	$17,301.61
Rate for Payer: MDWise Medicaid	$17,301.61

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

APR-DRG 36.00: TRANSIENT ISCHEMIA

Facility

$4,582.15

Service Code	APR-DRG 0473
Min. Negotiated Rate	$2,889.47
Max. Negotiated Rate	$4,582.15
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: TRANSIENT ISCHEMIA

Facility

$3,674.36

Service Code	APR-DRG 0472
Min. Negotiated Rate	$2,889.47
Max. Negotiated Rate	$3,674.36
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: TRANSIENT ISCHEMIA

Facility

$7,435.18

Service Code	APR-DRG 0474
Min. Negotiated Rate	$2,889.47
Max. Negotiated Rate	$7,435.18
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: TRANSIENT ISCHEMIA

Facility

$3,198.86

Service Code	APR-DRG 0471
Min. Negotiated Rate	$2,501.86
Max. Negotiated Rate	$3,198.86
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: TRANSURETHRAL PROSTATECTOMY

Facility

$11,325.68

Service Code	APR-DRG 4824
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$11,325.68
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,263.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,263.74
Rate for Payer: Managed Health Services Medicaid	$4,263.74
Rate for Payer: MDWise Medicaid	$4,263.74

APR-DRG 36.00: TRANSURETHRAL PROSTATECTOMY

Facility

$3,587.91

Service Code	APR-DRG 4821
Min. Negotiated Rate	$2,642.81
Max. Negotiated Rate	$3,587.91
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: TRANSURETHRAL PROSTATECTOMY

Facility

$8,256.51

Service Code	APR-DRG 4823
Min. Negotiated Rate	$4,263.74
Max. Negotiated Rate	$8,256.51
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,263.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,263.74
Rate for Payer: Managed Health Services Medicaid	$4,263.74
Rate for Payer: MDWise Medicaid	$4,263.74

APR-DRG 36.00: TRANSURETHRAL PROSTATECTOMY

Facility

$5,100.88

Service Code	APR-DRG 4822
Min. Negotiated Rate	$2,924.71
Max. Negotiated Rate	$5,100.88
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: URETHRAL & TRANSURETHRAL PROCEDURES

Facility

$4,106.64

Service Code	APR-DRG 4461
Min. Negotiated Rate	$3,594.22
Max. Negotiated Rate	$4,106.64
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: URETHRAL & TRANSURETHRAL PROCEDURES

Facility

$5,360.25

Service Code	APR-DRG 4462
Min. Negotiated Rate	$3,876.12
Max. Negotiated Rate	$5,360.25
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: URETHRAL & TRANSURETHRAL PROCEDURES

Facility

$8,040.37

Service Code	APR-DRG 4463
Min. Negotiated Rate	$4,369.45
Max. Negotiated Rate	$8,040.37
Rate for Payer: Anthem Blue Cross of IN Medicaid	$4,369.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$4,369.45
Rate for Payer: Managed Health Services Medicaid	$4,369.45
Rate for Payer: MDWise Medicaid	$4,369.45

APR-DRG 36.00: URETHRAL & TRANSURETHRAL PROCEDURES

Facility

$12,838.66

Service Code	APR-DRG 4464
Min. Negotiated Rate	$9,020.80
Max. Negotiated Rate	$12,838.66
Rate for Payer: Anthem Blue Cross of IN Medicaid	$9,020.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$9,020.80
Rate for Payer: Managed Health Services Medicaid	$9,020.80
Rate for Payer: MDWise Medicaid	$9,020.80

APR-DRG 36.00: URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$2,766.58

Service Code	APR-DRG 4651
Min. Negotiated Rate	$2,396.15
Max. Negotiated Rate	$2,766.58
Rate for Payer: Anthem Blue Cross of IN Medicaid	$2,396.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$2,396.15
Rate for Payer: Managed Health Services Medicaid	$2,396.15
Rate for Payer: MDWise Medicaid	$2,396.15

APR-DRG 36.00: URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$3,415.00

Service Code	APR-DRG 4652
Min. Negotiated Rate	$2,678.05
Max. Negotiated Rate	$3,415.00
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: URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$4,971.20

Service Code	APR-DRG 4653
Min. Negotiated Rate	$3,065.66
Max. Negotiated Rate	$4,971.20
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: URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$8,991.38

Service Code	APR-DRG 4654
Min. Negotiated Rate	$5,179.91
Max. Negotiated Rate	$8,991.38
Rate for Payer: Anthem Blue Cross of IN Medicaid	$5,179.91
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$5,179.91
Rate for Payer: Managed Health Services Medicaid	$5,179.91
Rate for Payer: MDWise Medicaid	$5,179.91

APR-DRG 36.00: UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$4,279.55

Service Code	APR-DRG 5191
Min. Negotiated Rate	$3,558.99
Max. Negotiated Rate	$4,279.55
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: UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$16,988.53

Service Code	APR-DRG 5194
Min. Negotiated Rate	$6,659.89
Max. Negotiated Rate	$16,988.53
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: UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$10,244.99

Service Code	APR-DRG 5193
Min. Negotiated Rate	$6,659.89
Max. Negotiated Rate	$10,244.99
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: UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA

Facility

$5,662.84

Service Code	APR-DRG 5192
Min. Negotiated Rate	$3,876.12
Max. Negotiated Rate	$5,662.84
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: UTERINE & ADNEXA PROCEDURES FOR NONMALIGNANCY EXCEPT LEIOMYOMA

Facility

$16,902.07

Service Code	APR-DRG 5134
Min. Negotiated Rate	$6,659.89
Max. Negotiated Rate	$16,902.07
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: UTERINE & ADNEXA PROCEDURES FOR NONMALIGNANCY EXCEPT LEIOMYOMA

Facility

$9,380.43

Service Code	APR-DRG 5133
Min. Negotiated Rate	$6,131.32
Max. Negotiated Rate	$9,380.43
Rate for Payer: Anthem Blue Cross of IN Medicaid	$6,131.32
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP	$6,131.32
Rate for Payer: Managed Health Services Medicaid	$6,131.32
Rate for Payer: MDWise Medicaid	$6,131.32

Know your out-of-pocket cost for care.

All Charges