Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm

Facility OP

$1,044.85

Service Code	CPT 11423
Hospital Charge Code	CPT-11423
Hospital Revenue Code	360
Min. Negotiated Rate	$1,044.85
Max. Negotiated Rate	$1,044.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,044.85
Rate for Payer: Managed Health Services Medicaid	$1,044.85
Rate for Payer: MDWise Medicaid	$1,044.85

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm

Facility OP

$1,728.79

Service Code	CPT 11424
Hospital Charge Code	CPT-11424
Hospital Revenue Code	360
Min. Negotiated Rate	$1,728.79
Max. Negotiated Rate	$1,728.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,728.79
Rate for Payer: Managed Health Services Medicaid	$1,728.79
Rate for Payer: MDWise Medicaid	$1,728.79

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm

Facility OP

$1,728.79

Service Code	CPT 11426
Hospital Charge Code	CPT-11426
Hospital Revenue Code	360
Min. Negotiated Rate	$1,728.79
Max. Negotiated Rate	$1,728.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,728.79
Rate for Payer: Managed Health Services Medicaid	$1,728.79
Rate for Payer: MDWise Medicaid	$1,728.79

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less

Facility OP

$381.15

Service Code	CPT 11400
Hospital Charge Code	CPT-11400
Hospital Revenue Code	360
Min. Negotiated Rate	$381.15
Max. Negotiated Rate	$381.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$381.15
Rate for Payer: Managed Health Services Medicaid	$381.15
Rate for Payer: MDWise Medicaid	$381.15

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm

Facility OP

$648.18

Service Code	CPT 11401
Hospital Charge Code	CPT-11401
Hospital Revenue Code	360
Min. Negotiated Rate	$648.18
Max. Negotiated Rate	$648.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$648.18
Rate for Payer: Managed Health Services Medicaid	$648.18
Rate for Payer: MDWise Medicaid	$648.18

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm

Facility OP

$648.18

Service Code	CPT 11402
Hospital Charge Code	CPT-11402
Hospital Revenue Code	360
Min. Negotiated Rate	$648.18
Max. Negotiated Rate	$648.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$648.18
Rate for Payer: Managed Health Services Medicaid	$648.18
Rate for Payer: MDWise Medicaid	$648.18

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm

Facility OP

$1,044.85

Service Code	CPT 11403
Hospital Charge Code	CPT-11403
Hospital Revenue Code	360
Min. Negotiated Rate	$1,044.85
Max. Negotiated Rate	$1,044.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,044.85
Rate for Payer: Managed Health Services Medicaid	$1,044.85
Rate for Payer: MDWise Medicaid	$1,044.85

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm

Facility OP

$1,242.31

Service Code	CPT 11404
Hospital Charge Code	CPT-11404
Hospital Revenue Code	360
Min. Negotiated Rate	$1,242.31
Max. Negotiated Rate	$1,242.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,242.31
Rate for Payer: Managed Health Services Medicaid	$1,242.31
Rate for Payer: MDWise Medicaid	$1,242.31

Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm

Facility OP

$1,728.79

Service Code	CPT 11406
Hospital Charge Code	CPT-11406
Hospital Revenue Code	360
Min. Negotiated Rate	$1,728.79
Max. Negotiated Rate	$1,728.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,728.79
Rate for Payer: Managed Health Services Medicaid	$1,728.79
Rate for Payer: MDWise Medicaid	$1,728.79

Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm

Facility OP

$1,283.57

Service Code	CPT 11641
Hospital Charge Code	CPT-11641
Hospital Revenue Code	360
Min. Negotiated Rate	$1,283.57
Max. Negotiated Rate	$1,283.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,283.57
Rate for Payer: Managed Health Services Medicaid	$1,283.57
Rate for Payer: MDWise Medicaid	$1,283.57

Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm

Facility OP

$1,283.57

Service Code	CPT 11642
Hospital Charge Code	CPT-11642
Hospital Revenue Code	360
Min. Negotiated Rate	$1,283.57
Max. Negotiated Rate	$1,283.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,283.57
Rate for Payer: Managed Health Services Medicaid	$1,283.57
Rate for Payer: MDWise Medicaid	$1,283.57

Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm

Facility OP

$1,283.57

Service Code	CPT 11643
Hospital Charge Code	CPT-11643
Hospital Revenue Code	360
Min. Negotiated Rate	$1,283.57
Max. Negotiated Rate	$1,283.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,283.57
Rate for Payer: Managed Health Services Medicaid	$1,283.57
Rate for Payer: MDWise Medicaid	$1,283.57

Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm

Facility OP

$1,044.85

Service Code	CPT 11621
Hospital Charge Code	CPT-11621
Hospital Revenue Code	360
Min. Negotiated Rate	$1,044.85
Max. Negotiated Rate	$1,044.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,044.85
Rate for Payer: Managed Health Services Medicaid	$1,044.85
Rate for Payer: MDWise Medicaid	$1,044.85

Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm

Facility OP

$1,044.85

Service Code	CPT 11622
Hospital Charge Code	CPT-11622
Hospital Revenue Code	360
Min. Negotiated Rate	$1,044.85
Max. Negotiated Rate	$1,044.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,044.85
Rate for Payer: Managed Health Services Medicaid	$1,044.85
Rate for Payer: MDWise Medicaid	$1,044.85

Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm

Facility OP

$1,283.57

Service Code	CPT 11623
Hospital Charge Code	CPT-11623
Hospital Revenue Code	360
Min. Negotiated Rate	$1,283.57
Max. Negotiated Rate	$1,283.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,283.57
Rate for Payer: Managed Health Services Medicaid	$1,283.57
Rate for Payer: MDWise Medicaid	$1,283.57

Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm

Facility OP

$1,728.79

Service Code	CPT 11626
Hospital Charge Code	CPT-11626
Hospital Revenue Code	360
Min. Negotiated Rate	$1,728.79
Max. Negotiated Rate	$1,728.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,728.79
Rate for Payer: Managed Health Services Medicaid	$1,728.79
Rate for Payer: MDWise Medicaid	$1,728.79

Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm

Facility OP

$1,044.85

Service Code	CPT 11602
Hospital Charge Code	CPT-11602
Hospital Revenue Code	360
Min. Negotiated Rate	$1,044.85
Max. Negotiated Rate	$1,044.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,044.85
Rate for Payer: Managed Health Services Medicaid	$1,044.85
Rate for Payer: MDWise Medicaid	$1,044.85

Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm

Facility OP

$1,283.57

Service Code	CPT 11603
Hospital Charge Code	CPT-11603
Hospital Revenue Code	360
Min. Negotiated Rate	$1,283.57
Max. Negotiated Rate	$1,283.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,283.57
Rate for Payer: Managed Health Services Medicaid	$1,283.57
Rate for Payer: MDWise Medicaid	$1,283.57

Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm

Facility OP

$1,728.79

Service Code	CPT 11604
Hospital Charge Code	CPT-11604
Hospital Revenue Code	360
Min. Negotiated Rate	$1,728.79
Max. Negotiated Rate	$1,728.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,728.79
Rate for Payer: Managed Health Services Medicaid	$1,728.79
Rate for Payer: MDWise Medicaid	$1,728.79

Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion

Facility OP

$1,905.42

Service Code	CPT 19125
Hospital Charge Code	CPT-19125
Hospital Revenue Code	360
Min. Negotiated Rate	$1,905.42
Max. Negotiated Rate	$1,905.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,905.42
Rate for Payer: Managed Health Services Medicaid	$1,905.42
Rate for Payer: MDWise Medicaid	$1,905.42

Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions

Facility OP

$1,905.42

Service Code	CPT 19120
Hospital Charge Code	CPT-19120
Hospital Revenue Code	360
Min. Negotiated Rate	$1,905.42
Max. Negotiated Rate	$1,905.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,905.42
Rate for Payer: Managed Health Services Medicaid	$1,905.42
Rate for Payer: MDWise Medicaid	$1,905.42

Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger

Facility OP

$1,905.42

Service Code	CPT 26160
Hospital Charge Code	CPT-26160
Hospital Revenue Code	360
Min. Negotiated Rate	$1,905.42
Max. Negotiated Rate	$1,905.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,905.42
Rate for Payer: Managed Health Services Medicaid	$1,905.42
Rate for Payer: MDWise Medicaid	$1,905.42

Excision of multiple external papillae or tags, anus

Facility OP

$648.18

Service Code	CPT 46230
Hospital Charge Code	CPT-46230
Hospital Revenue Code	360
Min. Negotiated Rate	$648.18
Max. Negotiated Rate	$648.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$648.18
Rate for Payer: Managed Health Services Medicaid	$648.18
Rate for Payer: MDWise Medicaid	$648.18

Excision of neuroma; hand or foot, except digital nerve

Facility OP

$1,905.42

Service Code	CPT 64782
Hospital Charge Code	CPT-64782
Hospital Revenue Code	360
Min. Negotiated Rate	$1,905.42
Max. Negotiated Rate	$1,905.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,905.42
Rate for Payer: Managed Health Services Medicaid	$1,905.42
Rate for Payer: MDWise Medicaid	$1,905.42

Excision of pilonidal cyst or sinus; complicated

Facility OP

$1,905.42

Service Code	CPT 11772
Hospital Charge Code	CPT-11772
Hospital Revenue Code	360
Min. Negotiated Rate	$1,905.42
Max. Negotiated Rate	$1,905.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,905.42
Rate for Payer: Managed Health Services Medicaid	$1,905.42
Rate for Payer: MDWise Medicaid	$1,905.42

Price Transparency.

All Charges