Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 0224: VENTRICULAR SHUNT PROCEDURES

Facility IP

$48,950.17

Service Code	APR-DRG 0224
Hospital Charge Code	APRDRG 0224
Min. Negotiated Rate	$10,028.78
Max. Negotiated Rate	$48,950.17
Rate for Payer: Buckeye Health Medicaid OOS	$10,028.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$48,950.17
Rate for Payer: Managed Health Services Medicaid	$48,950.17
Rate for Payer: MDWise Medicaid	$48,950.17
Rate for Payer: Molina Healthcare of OH Medicare	$10,028.78

INPATIENT APRDRG 0231: SPINAL PROCEDURES

Facility IP

$20,035.16

Service Code	APR-DRG 0231
Hospital Charge Code	APRDRG 0231
Min. Negotiated Rate	$5,053.62
Max. Negotiated Rate	$20,035.16
Rate for Payer: Buckeye Health Medicaid OOS	$5,053.62
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,035.16
Rate for Payer: Managed Health Services Medicaid	$20,035.16
Rate for Payer: MDWise Medicaid	$20,035.16
Rate for Payer: Molina Healthcare of OH Medicare	$5,053.62

INPATIENT APRDRG 0232: SPINAL PROCEDURES

Facility IP

$23,588.33

Service Code	APR-DRG 0232
Hospital Charge Code	APRDRG 0232
Min. Negotiated Rate	$7,041.51
Max. Negotiated Rate	$23,588.33
Rate for Payer: Buckeye Health Medicaid OOS	$7,041.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,588.33
Rate for Payer: Managed Health Services Medicaid	$23,588.33
Rate for Payer: MDWise Medicaid	$23,588.33
Rate for Payer: Molina Healthcare of OH Medicare	$7,041.51

INPATIENT APRDRG 0233: SPINAL PROCEDURES

Facility IP

$38,719.85

Service Code	APR-DRG 0233
Hospital Charge Code	APRDRG 0233
Min. Negotiated Rate	$12,463.05
Max. Negotiated Rate	$38,719.85
Rate for Payer: Buckeye Health Medicaid OOS	$12,463.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$38,719.85
Rate for Payer: Managed Health Services Medicaid	$38,719.85
Rate for Payer: MDWise Medicaid	$38,719.85
Rate for Payer: Molina Healthcare of OH Medicare	$12,463.05

INPATIENT APRDRG 0234: SPINAL PROCEDURES

Facility IP

$64,930.20

Service Code	APR-DRG 0234
Hospital Charge Code	APRDRG 0234
Min. Negotiated Rate	$15,759.01
Max. Negotiated Rate	$64,930.20
Rate for Payer: Buckeye Health Medicaid OOS	$15,759.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$64,930.20
Rate for Payer: Managed Health Services Medicaid	$64,930.20
Rate for Payer: MDWise Medicaid	$64,930.20
Rate for Payer: Molina Healthcare of OH Medicare	$15,759.01

INPATIENT APRDRG 0241: EXTRACRANIAL VASCULAR PROCEDURES

Facility IP

$19,237.21

Service Code	APR-DRG 0241
Hospital Charge Code	APRDRG 0241
Min. Negotiated Rate	$4,590.59
Max. Negotiated Rate	$19,237.21
Rate for Payer: Buckeye Health Medicaid OOS	$4,590.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,237.21
Rate for Payer: Managed Health Services Medicaid	$19,237.21
Rate for Payer: MDWise Medicaid	$19,237.21
Rate for Payer: Molina Healthcare of OH Medicare	$4,590.59

INPATIENT APRDRG 0242: EXTRACRANIAL VASCULAR PROCEDURES

Facility IP

$28,103.49

Service Code	APR-DRG 0242
Hospital Charge Code	APRDRG 0242
Min. Negotiated Rate	$5,416.42
Max. Negotiated Rate	$28,103.49
Rate for Payer: Buckeye Health Medicaid OOS	$5,416.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$28,103.49
Rate for Payer: Managed Health Services Medicaid	$28,103.49
Rate for Payer: MDWise Medicaid	$28,103.49
Rate for Payer: Molina Healthcare of OH Medicare	$5,416.42

INPATIENT APRDRG 0243: EXTRACRANIAL VASCULAR PROCEDURES

Facility IP

$33,687.93

Service Code	APR-DRG 0243
Hospital Charge Code	APRDRG 0243
Min. Negotiated Rate	$9,608.34
Max. Negotiated Rate	$33,687.93
Rate for Payer: Buckeye Health Medicaid OOS	$9,608.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$33,687.93
Rate for Payer: Managed Health Services Medicaid	$33,687.93
Rate for Payer: MDWise Medicaid	$33,687.93
Rate for Payer: Molina Healthcare of OH Medicare	$9,608.34

INPATIENT APRDRG 0244: EXTRACRANIAL VASCULAR PROCEDURES

Facility IP

$58,174.12

Service Code	APR-DRG 0244
Hospital Charge Code	APRDRG 0244
Min. Negotiated Rate	$16,097.80
Max. Negotiated Rate	$58,174.12
Rate for Payer: Buckeye Health Medicaid OOS	$16,097.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$58,174.12
Rate for Payer: Managed Health Services Medicaid	$58,174.12
Rate for Payer: MDWise Medicaid	$58,174.12
Rate for Payer: Molina Healthcare of OH Medicare	$16,097.80

INPATIENT APRDRG 0261: OTHER NERVOUS SYSTEM & RELATED PROCEDURES

Facility IP

$16,443.76

Service Code	APR-DRG 0261
Hospital Charge Code	APRDRG 0261
Min. Negotiated Rate	$3,985.70
Max. Negotiated Rate	$16,443.76
Rate for Payer: Buckeye Health Medicaid OOS	$3,985.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,443.76
Rate for Payer: Managed Health Services Medicaid	$16,443.76
Rate for Payer: MDWise Medicaid	$16,443.76
Rate for Payer: Molina Healthcare of OH Medicare	$3,985.70

INPATIENT APRDRG 0262: OTHER NERVOUS SYSTEM & RELATED PROCEDURES

Facility IP

$24,604.58

Service Code	APR-DRG 0262
Hospital Charge Code	APRDRG 0262
Min. Negotiated Rate	$5,403.29
Max. Negotiated Rate	$24,604.58
Rate for Payer: Buckeye Health Medicaid OOS	$5,403.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,604.58
Rate for Payer: Managed Health Services Medicaid	$24,604.58
Rate for Payer: MDWise Medicaid	$24,604.58
Rate for Payer: Molina Healthcare of OH Medicare	$5,403.29

INPATIENT APRDRG 0263: OTHER NERVOUS SYSTEM & RELATED PROCEDURES

Facility IP

$26,032.76

Service Code	APR-DRG 0263
Hospital Charge Code	APRDRG 0263
Min. Negotiated Rate	$7,849.09
Max. Negotiated Rate	$26,032.76
Rate for Payer: Buckeye Health Medicaid OOS	$7,849.09
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$26,032.76
Rate for Payer: Managed Health Services Medicaid	$26,032.76
Rate for Payer: MDWise Medicaid	$26,032.76
Rate for Payer: Molina Healthcare of OH Medicare	$7,849.09

INPATIENT APRDRG 0264: OTHER NERVOUS SYSTEM & RELATED PROCEDURES

Facility IP

$43,949.09

Service Code	APR-DRG 0264
Hospital Charge Code	APRDRG 0264
Min. Negotiated Rate	$7,849.09
Max. Negotiated Rate	$43,949.09
Rate for Payer: Buckeye Health Medicaid OOS	$7,849.09
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$43,949.09
Rate for Payer: Managed Health Services Medicaid	$43,949.09
Rate for Payer: MDWise Medicaid	$43,949.09
Rate for Payer: Molina Healthcare of OH Medicare	$7,849.09

INPATIENT APRDRG 0271: OTHER OPEN CRANIOTOMY

Facility IP

$6,621.71

Service Code	APR-DRG 0271
Hospital Charge Code	APRDRG 0271
Min. Negotiated Rate	$6,621.71
Max. Negotiated Rate	$6,621.71
Rate for Payer: Buckeye Health Medicaid OOS	$6,621.71
Rate for Payer: Molina Healthcare of OH Medicare	$6,621.71

INPATIENT APRDRG 0272: OTHER OPEN CRANIOTOMY

Facility IP

$8,241.67

Service Code	APR-DRG 0272
Hospital Charge Code	APRDRG 0272
Min. Negotiated Rate	$8,241.67
Max. Negotiated Rate	$8,241.67
Rate for Payer: Buckeye Health Medicaid OOS	$8,241.67
Rate for Payer: Molina Healthcare of OH Medicare	$8,241.67

INPATIENT APRDRG 0273: OTHER OPEN CRANIOTOMY

Facility IP

$12,918.07

Service Code	APR-DRG 0273
Hospital Charge Code	APRDRG 0273
Min. Negotiated Rate	$12,918.07
Max. Negotiated Rate	$12,918.07
Rate for Payer: Buckeye Health Medicaid OOS	$12,918.07
Rate for Payer: Molina Healthcare of OH Medicare	$12,918.07

INPATIENT APRDRG 0274: OTHER OPEN CRANIOTOMY

Facility IP

$22,808.20

Service Code	APR-DRG 0274
Hospital Charge Code	APRDRG 0274
Min. Negotiated Rate	$22,808.20
Max. Negotiated Rate	$22,808.20
Rate for Payer: Buckeye Health Medicaid OOS	$22,808.20
Rate for Payer: Molina Healthcare of OH Medicare	$22,808.20

INPATIENT APRDRG 0291: OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility IP

$6,562.47

Service Code	APR-DRG 0291
Hospital Charge Code	APRDRG 0291
Min. Negotiated Rate	$6,562.47
Max. Negotiated Rate	$6,562.47
Rate for Payer: Buckeye Health Medicaid OOS	$6,562.47
Rate for Payer: Molina Healthcare of OH Medicare	$6,562.47

INPATIENT APRDRG 0292: OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility IP

$8,101.73

Service Code	APR-DRG 0292
Hospital Charge Code	APRDRG 0292
Min. Negotiated Rate	$8,101.73
Max. Negotiated Rate	$8,101.73
Rate for Payer: Buckeye Health Medicaid OOS	$8,101.73
Rate for Payer: Molina Healthcare of OH Medicare	$8,101.73

INPATIENT APRDRG 0293: OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility IP

$12,725.62

Service Code	APR-DRG 0293
Hospital Charge Code	APRDRG 0293
Min. Negotiated Rate	$12,725.62
Max. Negotiated Rate	$12,725.62
Rate for Payer: Buckeye Health Medicaid OOS	$12,725.62
Rate for Payer: Molina Healthcare of OH Medicare	$12,725.62

INPATIENT APRDRG 0294: OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES

Facility IP

$23,312.22

Service Code	APR-DRG 0294
Hospital Charge Code	APRDRG 0294
Min. Negotiated Rate	$23,312.22
Max. Negotiated Rate	$23,312.22
Rate for Payer: Buckeye Health Medicaid OOS	$23,312.22
Rate for Payer: Molina Healthcare of OH Medicare	$23,312.22

INPATIENT APRDRG 0301: PERCUTANEOUS INTRA & EXTRACRANIAL VASCULAR PROCEDURES

Facility IP

$4,590.59

Service Code	APR-DRG 0301
Hospital Charge Code	APRDRG 0301
Min. Negotiated Rate	$4,590.59
Max. Negotiated Rate	$4,590.59
Rate for Payer: Buckeye Health Medicaid OOS	$4,590.59
Rate for Payer: Molina Healthcare of OH Medicare	$4,590.59

INPATIENT APRDRG 0302: PERCUTANEOUS INTRA & EXTRACRANIAL VASCULAR PROCEDURES

Facility IP

$5,416.42

Service Code	APR-DRG 0302
Hospital Charge Code	APRDRG 0302
Min. Negotiated Rate	$5,416.42
Max. Negotiated Rate	$5,416.42
Rate for Payer: Buckeye Health Medicaid OOS	$5,416.42
Rate for Payer: Molina Healthcare of OH Medicare	$5,416.42

INPATIENT APRDRG 0303: PERCUTANEOUS INTRA & EXTRACRANIAL VASCULAR PROCEDURES

Facility IP

$9,608.34

Service Code	APR-DRG 0303
Hospital Charge Code	APRDRG 0303
Min. Negotiated Rate	$9,608.34
Max. Negotiated Rate	$9,608.34
Rate for Payer: Buckeye Health Medicaid OOS	$9,608.34
Rate for Payer: Molina Healthcare of OH Medicare	$9,608.34

INPATIENT APRDRG 0304: PERCUTANEOUS INTRA & EXTRACRANIAL VASCULAR PROCEDURES

Facility IP

$16,097.80

Service Code	APR-DRG 0304
Hospital Charge Code	APRDRG 0304
Min. Negotiated Rate	$16,097.80
Max. Negotiated Rate	$16,097.80
Rate for Payer: Buckeye Health Medicaid OOS	$16,097.80
Rate for Payer: Molina Healthcare of OH Medicare	$16,097.80

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