Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 0584: OTHER DISORDERS OF NERVOUS SYSTEM

Facility IP

$40,952.14

Service Code	APR-DRG 0584
Hospital Charge Code	APRDRG 0584
Min. Negotiated Rate	$7,962.44
Max. Negotiated Rate	$40,952.14
Rate for Payer: Buckeye Health Medicaid OOS	$7,962.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$40,952.14
Rate for Payer: Managed Health Services Medicaid	$40,952.14
Rate for Payer: MDWise Medicaid	$40,952.14
Rate for Payer: Molina Healthcare of OH Medicare	$7,962.44

INPATIENT APRDRG 0591: ANOXIC & OTHER SEVERE BRAIN DAMAGE

Facility IP

$14,923.08

Service Code	APR-DRG 0591
Hospital Charge Code	APRDRG 0591
Min. Negotiated Rate	$3,543.81
Max. Negotiated Rate	$14,923.08
Rate for Payer: Buckeye Health Medicaid OOS	$3,543.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,923.08
Rate for Payer: Managed Health Services Medicaid	$14,923.08
Rate for Payer: MDWise Medicaid	$14,923.08
Rate for Payer: Molina Healthcare of OH Medicare	$3,543.81

INPATIENT APRDRG 0592: ANOXIC & OTHER SEVERE BRAIN DAMAGE

Facility IP

$14,923.08

Service Code	APR-DRG 0592
Hospital Charge Code	APRDRG 0592
Min. Negotiated Rate	$3,543.81
Max. Negotiated Rate	$14,923.08
Rate for Payer: Buckeye Health Medicaid OOS	$3,543.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,923.08
Rate for Payer: Managed Health Services Medicaid	$14,923.08
Rate for Payer: MDWise Medicaid	$14,923.08
Rate for Payer: Molina Healthcare of OH Medicare	$3,543.81

INPATIENT APRDRG 0593: ANOXIC & OTHER SEVERE BRAIN DAMAGE

Facility IP

$14,923.08

Service Code	APR-DRG 0593
Hospital Charge Code	APRDRG 0593
Min. Negotiated Rate	$7,460.67
Max. Negotiated Rate	$14,923.08
Rate for Payer: Buckeye Health Medicaid OOS	$7,460.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,923.08
Rate for Payer: Managed Health Services Medicaid	$14,923.08
Rate for Payer: MDWise Medicaid	$14,923.08
Rate for Payer: Molina Healthcare of OH Medicare	$7,460.67

INPATIENT APRDRG 0594: ANOXIC & OTHER SEVERE BRAIN DAMAGE

Facility IP

$21,664.37

Service Code	APR-DRG 0594
Hospital Charge Code	APRDRG 0594
Min. Negotiated Rate	$7,460.67
Max. Negotiated Rate	$21,664.37
Rate for Payer: Buckeye Health Medicaid OOS	$7,460.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,664.37
Rate for Payer: Managed Health Services Medicaid	$21,664.37
Rate for Payer: MDWise Medicaid	$21,664.37
Rate for Payer: Molina Healthcare of OH Medicare	$7,460.67

INPATIENT APRDRG 0731: ORBIT AND EYE PROCEDURES

Facility IP

$12,488.52

Service Code	APR-DRG 0731
Hospital Charge Code	APRDRG 0731
Min. Negotiated Rate	$3,214.63
Max. Negotiated Rate	$12,488.52
Rate for Payer: Buckeye Health Medicaid OOS	$3,214.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,488.52
Rate for Payer: Managed Health Services Medicaid	$12,488.52
Rate for Payer: MDWise Medicaid	$12,488.52
Rate for Payer: Molina Healthcare of OH Medicare	$3,214.63

INPATIENT APRDRG 0732: ORBIT AND EYE PROCEDURES

Facility IP

$14,661.62

Service Code	APR-DRG 0732
Hospital Charge Code	APRDRG 0732
Min. Negotiated Rate	$5,270.08
Max. Negotiated Rate	$14,661.62
Rate for Payer: Buckeye Health Medicaid OOS	$5,270.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,661.62
Rate for Payer: Managed Health Services Medicaid	$14,661.62
Rate for Payer: MDWise Medicaid	$14,661.62
Rate for Payer: Molina Healthcare of OH Medicare	$5,270.08

INPATIENT APRDRG 0733: ORBIT AND EYE PROCEDURES

Facility IP

$23,160.38

Service Code	APR-DRG 0733
Hospital Charge Code	APRDRG 0733
Min. Negotiated Rate	$5,270.08
Max. Negotiated Rate	$23,160.38
Rate for Payer: Buckeye Health Medicaid OOS	$5,270.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,160.38
Rate for Payer: Managed Health Services Medicaid	$23,160.38
Rate for Payer: MDWise Medicaid	$23,160.38
Rate for Payer: Molina Healthcare of OH Medicare	$5,270.08

INPATIENT APRDRG 0734: ORBIT AND EYE PROCEDURES

Facility IP

$23,160.38

Service Code	APR-DRG 0734
Hospital Charge Code	APRDRG 0734
Min. Negotiated Rate	$5,270.08
Max. Negotiated Rate	$23,160.38
Rate for Payer: Buckeye Health Medicaid OOS	$5,270.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,160.38
Rate for Payer: Managed Health Services Medicaid	$23,160.38
Rate for Payer: MDWise Medicaid	$23,160.38
Rate for Payer: Molina Healthcare of OH Medicare	$5,270.08

INPATIENT APRDRG 0821: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility IP

$7,546.64

Service Code	APR-DRG 0821
Hospital Charge Code	APRDRG 0821
Min. Negotiated Rate	$1,950.10
Max. Negotiated Rate	$7,546.64
Rate for Payer: Buckeye Health Medicaid OOS	$1,950.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,546.64
Rate for Payer: Managed Health Services Medicaid	$7,546.64
Rate for Payer: MDWise Medicaid	$7,546.64
Rate for Payer: Molina Healthcare of OH Medicare	$1,950.10

INPATIENT APRDRG 0822: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility IP

$9,095.68

Service Code	APR-DRG 0822
Hospital Charge Code	APRDRG 0822
Min. Negotiated Rate	$2,062.18
Max. Negotiated Rate	$9,095.68
Rate for Payer: Buckeye Health Medicaid OOS	$2,062.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,095.68
Rate for Payer: Managed Health Services Medicaid	$9,095.68
Rate for Payer: MDWise Medicaid	$9,095.68
Rate for Payer: Molina Healthcare of OH Medicare	$2,062.18

INPATIENT APRDRG 0823: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility IP

$11,073.91

Service Code	APR-DRG 0823
Hospital Charge Code	APRDRG 0823
Min. Negotiated Rate	$3,750.99
Max. Negotiated Rate	$11,073.91
Rate for Payer: Buckeye Health Medicaid OOS	$3,750.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,073.91
Rate for Payer: Managed Health Services Medicaid	$11,073.91
Rate for Payer: MDWise Medicaid	$11,073.91
Rate for Payer: Molina Healthcare of OH Medicare	$3,750.99

INPATIENT APRDRG 0824: EYE INFECTIONS AND OTHER EYE DISORDERS

Facility IP

$14,775.08

Service Code	APR-DRG 0824
Hospital Charge Code	APRDRG 0824
Min. Negotiated Rate	$3,750.99
Max. Negotiated Rate	$14,775.08
Rate for Payer: Buckeye Health Medicaid OOS	$3,750.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,775.08
Rate for Payer: Managed Health Services Medicaid	$14,775.08
Rate for Payer: MDWise Medicaid	$14,775.08
Rate for Payer: Molina Healthcare of OH Medicare	$3,750.99

INPATIENT APRDRG 0891: MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility IP

$18,880.78

Service Code	APR-DRG 0891
Hospital Charge Code	APRDRG 0891
Min. Negotiated Rate	$5,885.53
Max. Negotiated Rate	$18,880.78
Rate for Payer: Buckeye Health Medicaid OOS	$5,885.53
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,880.78
Rate for Payer: Managed Health Services Medicaid	$18,880.78
Rate for Payer: MDWise Medicaid	$18,880.78
Rate for Payer: Molina Healthcare of OH Medicare	$5,885.53

INPATIENT APRDRG 0892: MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility IP

$49,529.83

Service Code	APR-DRG 0892
Hospital Charge Code	APRDRG 0892
Min. Negotiated Rate	$7,070.00
Max. Negotiated Rate	$49,529.83
Rate for Payer: Buckeye Health Medicaid OOS	$7,070.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$49,529.83
Rate for Payer: Managed Health Services Medicaid	$49,529.83
Rate for Payer: MDWise Medicaid	$49,529.83
Rate for Payer: Molina Healthcare of OH Medicare	$7,070.00

INPATIENT APRDRG 0893: MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility IP

$58,718.01

Service Code	APR-DRG 0893
Hospital Charge Code	APRDRG 0893
Min. Negotiated Rate	$11,105.34
Max. Negotiated Rate	$58,718.01
Rate for Payer: Buckeye Health Medicaid OOS	$11,105.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$58,718.01
Rate for Payer: Managed Health Services Medicaid	$58,718.01
Rate for Payer: MDWise Medicaid	$58,718.01
Rate for Payer: Molina Healthcare of OH Medicare	$11,105.34

INPATIENT APRDRG 0894: MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility IP

$78,290.68

Service Code	APR-DRG 0894
Hospital Charge Code	APRDRG 0894
Min. Negotiated Rate	$13,472.68
Max. Negotiated Rate	$78,290.68
Rate for Payer: Buckeye Health Medicaid OOS	$13,472.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$78,290.68
Rate for Payer: Managed Health Services Medicaid	$78,290.68
Rate for Payer: MDWise Medicaid	$78,290.68
Rate for Payer: Molina Healthcare of OH Medicare	$13,472.68

INPATIENT APRDRG 0911: OTHER MAJOR HEAD & NECK PROCEDURES

Facility IP

$23,064.18

Service Code	APR-DRG 0911
Hospital Charge Code	APRDRG 0911
Min. Negotiated Rate	$4,006.52
Max. Negotiated Rate	$23,064.18
Rate for Payer: Buckeye Health Medicaid OOS	$4,006.52
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,064.18
Rate for Payer: Managed Health Services Medicaid	$23,064.18
Rate for Payer: MDWise Medicaid	$23,064.18
Rate for Payer: Molina Healthcare of OH Medicare	$4,006.52

INPATIENT APRDRG 0912: OTHER MAJOR HEAD & NECK PROCEDURES

Facility IP

$25,190.41

Service Code	APR-DRG 0912
Hospital Charge Code	APRDRG 0912
Min. Negotiated Rate	$7,296.08
Max. Negotiated Rate	$25,190.41
Rate for Payer: Buckeye Health Medicaid OOS	$7,296.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,190.41
Rate for Payer: Managed Health Services Medicaid	$25,190.41
Rate for Payer: MDWise Medicaid	$25,190.41
Rate for Payer: Molina Healthcare of OH Medicare	$7,296.08

INPATIENT APRDRG 0913: OTHER MAJOR HEAD & NECK PROCEDURES

Facility IP

$35,677.26

Service Code	APR-DRG 0913
Hospital Charge Code	APRDRG 0913
Min. Negotiated Rate	$14,019.61
Max. Negotiated Rate	$35,677.26
Rate for Payer: Buckeye Health Medicaid OOS	$14,019.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$35,677.26
Rate for Payer: Managed Health Services Medicaid	$35,677.26
Rate for Payer: MDWise Medicaid	$35,677.26
Rate for Payer: Molina Healthcare of OH Medicare	$14,019.61

INPATIENT APRDRG 0914: OTHER MAJOR HEAD & NECK PROCEDURES

Facility IP

$62,350.11

Service Code	APR-DRG 0914
Hospital Charge Code	APRDRG 0914
Min. Negotiated Rate	$14,019.61
Max. Negotiated Rate	$62,350.11
Rate for Payer: Buckeye Health Medicaid OOS	$14,019.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$62,350.11
Rate for Payer: Managed Health Services Medicaid	$62,350.11
Rate for Payer: MDWise Medicaid	$62,350.11
Rate for Payer: Molina Healthcare of OH Medicare	$14,019.61

INPATIENT APRDRG 0921: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility IP

$19,047.28

Service Code	APR-DRG 0921
Hospital Charge Code	APRDRG 0921
Min. Negotiated Rate	$3,773.72
Max. Negotiated Rate	$19,047.28
Rate for Payer: Buckeye Health Medicaid OOS	$3,773.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,047.28
Rate for Payer: Managed Health Services Medicaid	$19,047.28
Rate for Payer: MDWise Medicaid	$19,047.28
Rate for Payer: Molina Healthcare of OH Medicare	$3,773.72

INPATIENT APRDRG 0922: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility IP

$19,047.28

Service Code	APR-DRG 0922
Hospital Charge Code	APRDRG 0922
Min. Negotiated Rate	$4,664.24
Max. Negotiated Rate	$19,047.28
Rate for Payer: Buckeye Health Medicaid OOS	$4,664.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,047.28
Rate for Payer: Managed Health Services Medicaid	$19,047.28
Rate for Payer: MDWise Medicaid	$19,047.28
Rate for Payer: Molina Healthcare of OH Medicare	$4,664.24

INPATIENT APRDRG 0923: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility IP

$33,000.98

Service Code	APR-DRG 0923
Hospital Charge Code	APRDRG 0923
Min. Negotiated Rate	$11,720.15
Max. Negotiated Rate	$33,000.98
Rate for Payer: Buckeye Health Medicaid OOS	$11,720.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$33,000.98
Rate for Payer: Managed Health Services Medicaid	$33,000.98
Rate for Payer: MDWise Medicaid	$33,000.98
Rate for Payer: Molina Healthcare of OH Medicare	$11,720.15

INPATIENT APRDRG 0924: FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL/FACIAL BONE PROCEDURES

Facility IP

$62,625.14

Service Code	APR-DRG 0924
Hospital Charge Code	APRDRG 0924
Min. Negotiated Rate	$11,720.15
Max. Negotiated Rate	$62,625.14
Rate for Payer: Buckeye Health Medicaid OOS	$11,720.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$62,625.14
Rate for Payer: Managed Health Services Medicaid	$62,625.14
Rate for Payer: MDWise Medicaid	$62,625.14
Rate for Payer: Molina Healthcare of OH Medicare	$11,720.15

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