Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 0523: ALTERATION IN CONSCIOUSNESS

Facility IP

$13,721.83

Service Code	APR-DRG 0523
Hospital Charge Code	APRDRG 0523
Min. Negotiated Rate	$3,099.99
Max. Negotiated Rate	$13,721.83
Rate for Payer: Buckeye Health Medicaid OOS	$3,099.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,721.83
Rate for Payer: Managed Health Services Medicaid	$13,721.83
Rate for Payer: MDWise Medicaid	$13,721.83
Rate for Payer: Molina Healthcare of OH Medicare	$3,099.99

INPATIENT APRDRG 0524: ALTERATION IN CONSCIOUSNESS

Facility IP

$28,652.32

Service Code	APR-DRG 0524
Hospital Charge Code	APRDRG 0524
Min. Negotiated Rate	$7,400.47
Max. Negotiated Rate	$28,652.32
Rate for Payer: Buckeye Health Medicaid OOS	$7,400.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$28,652.32
Rate for Payer: Managed Health Services Medicaid	$28,652.32
Rate for Payer: MDWise Medicaid	$28,652.32
Rate for Payer: Molina Healthcare of OH Medicare	$7,400.47

INPATIENT APRDRG 0531: SEIZURE

Facility IP

$7,227.21

Service Code	APR-DRG 0531
Hospital Charge Code	APRDRG 0531
Min. Negotiated Rate	$1,907.51
Max. Negotiated Rate	$7,227.21
Rate for Payer: Buckeye Health Medicaid OOS	$1,907.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,227.21
Rate for Payer: Managed Health Services Medicaid	$7,227.21
Rate for Payer: MDWise Medicaid	$7,227.21
Rate for Payer: Molina Healthcare of OH Medicare	$1,907.51

INPATIENT APRDRG 0532: SEIZURE

Facility IP

$9,205.44

Service Code	APR-DRG 0532
Hospital Charge Code	APRDRG 0532
Min. Negotiated Rate	$2,101.24
Max. Negotiated Rate	$9,205.44
Rate for Payer: Buckeye Health Medicaid OOS	$2,101.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,205.44
Rate for Payer: Managed Health Services Medicaid	$9,205.44
Rate for Payer: MDWise Medicaid	$9,205.44
Rate for Payer: Molina Healthcare of OH Medicare	$2,101.24

INPATIENT APRDRG 0533: SEIZURE

Facility IP

$12,042.06

Service Code	APR-DRG 0533
Hospital Charge Code	APRDRG 0533
Min. Negotiated Rate	$2,869.12
Max. Negotiated Rate	$12,042.06
Rate for Payer: Buckeye Health Medicaid OOS	$2,869.12
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,042.06
Rate for Payer: Managed Health Services Medicaid	$12,042.06
Rate for Payer: MDWise Medicaid	$12,042.06
Rate for Payer: Molina Healthcare of OH Medicare	$2,869.12

INPATIENT APRDRG 0534: SEIZURE

Facility IP

$27,511.50

Service Code	APR-DRG 0534
Hospital Charge Code	APRDRG 0534
Min. Negotiated Rate	$7,377.41
Max. Negotiated Rate	$27,511.50
Rate for Payer: Buckeye Health Medicaid OOS	$7,377.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$27,511.50
Rate for Payer: Managed Health Services Medicaid	$27,511.50
Rate for Payer: MDWise Medicaid	$27,511.50
Rate for Payer: Molina Healthcare of OH Medicare	$7,377.41

INPATIENT APRDRG 0541: MIGRAINE & OTHER HEADACHES

Facility IP

$8,789.82

Service Code	APR-DRG 0541
Hospital Charge Code	APRDRG 0541
Min. Negotiated Rate	$1,689.45
Max. Negotiated Rate	$8,789.82
Rate for Payer: Buckeye Health Medicaid OOS	$1,689.45
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,789.82
Rate for Payer: Managed Health Services Medicaid	$8,789.82
Rate for Payer: MDWise Medicaid	$8,789.82
Rate for Payer: Molina Healthcare of OH Medicare	$1,689.45

INPATIENT APRDRG 0542: MIGRAINE & OTHER HEADACHES

Facility IP

$10,158.80

Service Code	APR-DRG 0542
Hospital Charge Code	APRDRG 0542
Min. Negotiated Rate	$1,922.24
Max. Negotiated Rate	$10,158.80
Rate for Payer: Buckeye Health Medicaid OOS	$1,922.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,158.80
Rate for Payer: Managed Health Services Medicaid	$10,158.80
Rate for Payer: MDWise Medicaid	$10,158.80
Rate for Payer: Molina Healthcare of OH Medicare	$1,922.24

INPATIENT APRDRG 0543: MIGRAINE & OTHER HEADACHES

Facility IP

$11,704.14

Service Code	APR-DRG 0543
Hospital Charge Code	APRDRG 0543
Min. Negotiated Rate	$2,583.49
Max. Negotiated Rate	$11,704.14
Rate for Payer: Buckeye Health Medicaid OOS	$2,583.49
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,704.14
Rate for Payer: Managed Health Services Medicaid	$11,704.14
Rate for Payer: MDWise Medicaid	$11,704.14
Rate for Payer: Molina Healthcare of OH Medicare	$2,583.49

INPATIENT APRDRG 0544: MIGRAINE & OTHER HEADACHES

Facility IP

$11,704.14

Service Code	APR-DRG 0544
Hospital Charge Code	APRDRG 0544
Min. Negotiated Rate	$2,583.49
Max. Negotiated Rate	$11,704.14
Rate for Payer: Buckeye Health Medicaid OOS	$2,583.49
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,704.14
Rate for Payer: Managed Health Services Medicaid	$11,704.14
Rate for Payer: MDWise Medicaid	$11,704.14
Rate for Payer: Molina Healthcare of OH Medicare	$2,583.49

INPATIENT APRDRG 0551: HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE

Facility IP

$7,483.74

Service Code	APR-DRG 0551
Hospital Charge Code	APRDRG 0551
Min. Negotiated Rate	$1,909.12
Max. Negotiated Rate	$7,483.74
Rate for Payer: Buckeye Health Medicaid OOS	$1,909.12
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,483.74
Rate for Payer: Managed Health Services Medicaid	$7,483.74
Rate for Payer: MDWise Medicaid	$7,483.74
Rate for Payer: Molina Healthcare of OH Medicare	$1,909.12

INPATIENT APRDRG 0552: HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE

Facility IP

$12,951.01

Service Code	APR-DRG 0552
Hospital Charge Code	APRDRG 0552
Min. Negotiated Rate	$2,546.34
Max. Negotiated Rate	$12,951.01
Rate for Payer: Buckeye Health Medicaid OOS	$2,546.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,951.01
Rate for Payer: Managed Health Services Medicaid	$12,951.01
Rate for Payer: MDWise Medicaid	$12,951.01
Rate for Payer: Molina Healthcare of OH Medicare	$2,546.34

INPATIENT APRDRG 0553: HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE

Facility IP

$19,545.54

Service Code	APR-DRG 0553
Hospital Charge Code	APRDRG 0553
Min. Negotiated Rate	$4,872.06
Max. Negotiated Rate	$19,545.54
Rate for Payer: Buckeye Health Medicaid OOS	$4,872.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,545.54
Rate for Payer: Managed Health Services Medicaid	$19,545.54
Rate for Payer: MDWise Medicaid	$19,545.54
Rate for Payer: Molina Healthcare of OH Medicare	$4,872.06

INPATIENT APRDRG 0554: HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE

Facility IP

$36,926.61

Service Code	APR-DRG 0554
Hospital Charge Code	APRDRG 0554
Min. Negotiated Rate	$9,864.51
Max. Negotiated Rate	$36,926.61
Rate for Payer: Buckeye Health Medicaid OOS	$9,864.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$36,926.61
Rate for Payer: Managed Health Services Medicaid	$36,926.61
Rate for Payer: MDWise Medicaid	$36,926.61
Rate for Payer: Molina Healthcare of OH Medicare	$9,864.51

INPATIENT APRDRG 0561: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility IP

$6,228.23

Service Code	APR-DRG 0561
Hospital Charge Code	APRDRG 0561
Min. Negotiated Rate	$2,352.93
Max. Negotiated Rate	$6,228.23
Rate for Payer: Buckeye Health Medicaid OOS	$2,352.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,228.23
Rate for Payer: Managed Health Services Medicaid	$6,228.23
Rate for Payer: MDWise Medicaid	$6,228.23
Rate for Payer: Molina Healthcare of OH Medicare	$2,352.93

INPATIENT APRDRG 0562: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility IP

$9,442.24

Service Code	APR-DRG 0562
Hospital Charge Code	APRDRG 0562
Min. Negotiated Rate	$2,352.93
Max. Negotiated Rate	$9,442.24
Rate for Payer: Buckeye Health Medicaid OOS	$2,352.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,442.24
Rate for Payer: Managed Health Services Medicaid	$9,442.24
Rate for Payer: MDWise Medicaid	$9,442.24
Rate for Payer: Molina Healthcare of OH Medicare	$2,352.93

INPATIENT APRDRG 0563: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility IP

$9,442.24

Service Code	APR-DRG 0563
Hospital Charge Code	APRDRG 0563
Min. Negotiated Rate	$2,352.93
Max. Negotiated Rate	$9,442.24
Rate for Payer: Buckeye Health Medicaid OOS	$2,352.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,442.24
Rate for Payer: Managed Health Services Medicaid	$9,442.24
Rate for Payer: MDWise Medicaid	$9,442.24
Rate for Payer: Molina Healthcare of OH Medicare	$2,352.93

INPATIENT APRDRG 0564: BRAIN CONTUSION/LACERATION & COMPLICATED SKULL FX, COMA < 1 HR OR NO COMA

Facility IP

$9,442.24

Service Code	APR-DRG 0564
Hospital Charge Code	APRDRG 0564
Min. Negotiated Rate	$2,352.93
Max. Negotiated Rate	$9,442.24
Rate for Payer: Buckeye Health Medicaid OOS	$2,352.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,442.24
Rate for Payer: Managed Health Services Medicaid	$9,442.24
Rate for Payer: MDWise Medicaid	$9,442.24
Rate for Payer: Molina Healthcare of OH Medicare	$2,352.93

INPATIENT APRDRG 0571: CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA

Facility IP

$6,843.65

Service Code	APR-DRG 0571
Hospital Charge Code	APRDRG 0571
Min. Negotiated Rate	$1,775.91
Max. Negotiated Rate	$6,843.65
Rate for Payer: Buckeye Health Medicaid OOS	$1,775.91
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,843.65
Rate for Payer: Managed Health Services Medicaid	$6,843.65
Rate for Payer: MDWise Medicaid	$6,843.65
Rate for Payer: Molina Healthcare of OH Medicare	$1,775.91

INPATIENT APRDRG 0572: CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA

Facility IP

$11,024.58

Service Code	APR-DRG 0572
Hospital Charge Code	APRDRG 0572
Min. Negotiated Rate	$1,907.51
Max. Negotiated Rate	$11,024.58
Rate for Payer: Buckeye Health Medicaid OOS	$1,907.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,024.58
Rate for Payer: Managed Health Services Medicaid	$11,024.58
Rate for Payer: MDWise Medicaid	$11,024.58
Rate for Payer: Molina Healthcare of OH Medicare	$1,907.51

INPATIENT APRDRG 0573: CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA

Facility IP

$12,520.59

Service Code	APR-DRG 0573
Hospital Charge Code	APRDRG 0573
Min. Negotiated Rate	$3,898.93
Max. Negotiated Rate	$12,520.59
Rate for Payer: Buckeye Health Medicaid OOS	$3,898.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,520.59
Rate for Payer: Managed Health Services Medicaid	$12,520.59
Rate for Payer: MDWise Medicaid	$12,520.59
Rate for Payer: Molina Healthcare of OH Medicare	$3,898.93

INPATIENT APRDRG 0574: CONCUSSION, CLOSED SKULL FX NOS,UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HR OR NO COMA

Facility IP

$21,812.36

Service Code	APR-DRG 0574
Hospital Charge Code	APRDRG 0574
Min. Negotiated Rate	$3,898.93
Max. Negotiated Rate	$21,812.36
Rate for Payer: Buckeye Health Medicaid OOS	$3,898.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,812.36
Rate for Payer: Managed Health Services Medicaid	$21,812.36
Rate for Payer: MDWise Medicaid	$21,812.36
Rate for Payer: Molina Healthcare of OH Medicare	$3,898.93

INPATIENT APRDRG 0581: OTHER DISORDERS OF NERVOUS SYSTEM

Facility IP

$14,627.09

Service Code	APR-DRG 0581
Hospital Charge Code	APRDRG 0581
Min. Negotiated Rate	$2,420.50
Max. Negotiated Rate	$14,627.09
Rate for Payer: Buckeye Health Medicaid OOS	$2,420.50
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,627.09
Rate for Payer: Managed Health Services Medicaid	$14,627.09
Rate for Payer: MDWise Medicaid	$14,627.09
Rate for Payer: Molina Healthcare of OH Medicare	$2,420.50

INPATIENT APRDRG 0582: OTHER DISORDERS OF NERVOUS SYSTEM

Facility IP

$21,142.68

Service Code	APR-DRG 0582
Hospital Charge Code	APRDRG 0582
Min. Negotiated Rate	$3,607.21
Max. Negotiated Rate	$21,142.68
Rate for Payer: Buckeye Health Medicaid OOS	$3,607.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,142.68
Rate for Payer: Managed Health Services Medicaid	$21,142.68
Rate for Payer: MDWise Medicaid	$21,142.68
Rate for Payer: Molina Healthcare of OH Medicare	$3,607.21

INPATIENT APRDRG 0583: OTHER DISORDERS OF NERVOUS SYSTEM

Facility IP

$26,346.02

Service Code	APR-DRG 0583
Hospital Charge Code	APRDRG 0583
Min. Negotiated Rate	$5,566.28
Max. Negotiated Rate	$26,346.02
Rate for Payer: Buckeye Health Medicaid OOS	$5,566.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$26,346.02
Rate for Payer: Managed Health Services Medicaid	$26,346.02
Rate for Payer: MDWise Medicaid	$26,346.02
Rate for Payer: Molina Healthcare of OH Medicare	$5,566.28

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