Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 1323: BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility IP

$12,779.58

Service Code	APR-DRG 1323
Hospital Charge Code	APRDRG 1323
Min. Negotiated Rate	$6,824.08
Max. Negotiated Rate	$12,779.58
Rate for Payer: Buckeye Health Medicaid OOS	$6,824.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,779.58
Rate for Payer: Managed Health Services Medicaid	$12,779.58
Rate for Payer: MDWise Medicaid	$12,779.58
Rate for Payer: Molina Healthcare of OH Medicare	$6,824.08

INPATIENT APRDRG 1324: BPD & OTH CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD

Facility IP

$73,412.93

Service Code	APR-DRG 1324
Hospital Charge Code	APRDRG 1324
Min. Negotiated Rate	$18,638.06
Max. Negotiated Rate	$73,412.93
Rate for Payer: Buckeye Health Medicaid OOS	$18,638.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$73,412.93
Rate for Payer: Managed Health Services Medicaid	$73,412.93
Rate for Payer: MDWise Medicaid	$73,412.93
Rate for Payer: Molina Healthcare of OH Medicare	$18,638.06

INPATIENT APRDRG 1331: RESPIRATORY FAILURE

Facility IP

$7,604.60

Service Code	APR-DRG 1331
Hospital Charge Code	APRDRG 1331
Min. Negotiated Rate	$1,930.57
Max. Negotiated Rate	$7,604.60
Rate for Payer: Buckeye Health Medicaid OOS	$1,930.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,604.60
Rate for Payer: Managed Health Services Medicaid	$7,604.60
Rate for Payer: MDWise Medicaid	$7,604.60
Rate for Payer: Molina Healthcare of OH Medicare	$1,930.57

INPATIENT APRDRG 1332: RESPIRATORY FAILURE

Facility IP

$11,160.24

Service Code	APR-DRG 1332
Hospital Charge Code	APRDRG 1332
Min. Negotiated Rate	$2,458.60
Max. Negotiated Rate	$11,160.24
Rate for Payer: Buckeye Health Medicaid OOS	$2,458.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,160.24
Rate for Payer: Managed Health Services Medicaid	$11,160.24
Rate for Payer: MDWise Medicaid	$11,160.24
Rate for Payer: Molina Healthcare of OH Medicare	$2,458.60

INPATIENT APRDRG 1333: RESPIRATORY FAILURE

Facility IP

$16,174.89

Service Code	APR-DRG 1333
Hospital Charge Code	APRDRG 1333
Min. Negotiated Rate	$3,500.90
Max. Negotiated Rate	$16,174.89
Rate for Payer: Buckeye Health Medicaid OOS	$3,500.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,174.89
Rate for Payer: Managed Health Services Medicaid	$16,174.89
Rate for Payer: MDWise Medicaid	$16,174.89
Rate for Payer: Molina Healthcare of OH Medicare	$3,500.90

INPATIENT APRDRG 1334: RESPIRATORY FAILURE

Facility IP

$26,992.28

Service Code	APR-DRG 1334
Hospital Charge Code	APRDRG 1334
Min. Negotiated Rate	$6,175.97
Max. Negotiated Rate	$26,992.28
Rate for Payer: Buckeye Health Medicaid OOS	$6,175.97
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$26,992.28
Rate for Payer: Managed Health Services Medicaid	$26,992.28
Rate for Payer: MDWise Medicaid	$26,992.28
Rate for Payer: Molina Healthcare of OH Medicare	$6,175.97

INPATIENT APRDRG 1341: PULMONARY EMBOLISM

Facility IP

$10,964.15

Service Code	APR-DRG 1341
Hospital Charge Code	APRDRG 1341
Min. Negotiated Rate	$1,762.78
Max. Negotiated Rate	$10,964.15
Rate for Payer: Buckeye Health Medicaid OOS	$1,762.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,964.15
Rate for Payer: Managed Health Services Medicaid	$10,964.15
Rate for Payer: MDWise Medicaid	$10,964.15
Rate for Payer: Molina Healthcare of OH Medicare	$1,762.78

INPATIENT APRDRG 1342: PULMONARY EMBOLISM

Facility IP

$11,034.45

Service Code	APR-DRG 1342
Hospital Charge Code	APRDRG 1342
Min. Negotiated Rate	$2,177.78
Max. Negotiated Rate	$11,034.45
Rate for Payer: Buckeye Health Medicaid OOS	$2,177.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,034.45
Rate for Payer: Managed Health Services Medicaid	$11,034.45
Rate for Payer: MDWise Medicaid	$11,034.45
Rate for Payer: Molina Healthcare of OH Medicare	$2,177.78

INPATIENT APRDRG 1343: PULMONARY EMBOLISM

Facility IP

$15,829.57

Service Code	APR-DRG 1343
Hospital Charge Code	APRDRG 1343
Min. Negotiated Rate	$3,484.57
Max. Negotiated Rate	$15,829.57
Rate for Payer: Buckeye Health Medicaid OOS	$3,484.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,829.57
Rate for Payer: Managed Health Services Medicaid	$15,829.57
Rate for Payer: MDWise Medicaid	$15,829.57
Rate for Payer: Molina Healthcare of OH Medicare	$3,484.57

INPATIENT APRDRG 1344: PULMONARY EMBOLISM

Facility IP

$27,435.04

Service Code	APR-DRG 1344
Hospital Charge Code	APRDRG 1344
Min. Negotiated Rate	$5,927.80
Max. Negotiated Rate	$27,435.04
Rate for Payer: Buckeye Health Medicaid OOS	$5,927.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$27,435.04
Rate for Payer: Managed Health Services Medicaid	$27,435.04
Rate for Payer: MDWise Medicaid	$27,435.04
Rate for Payer: Molina Healthcare of OH Medicare	$5,927.80

INPATIENT APRDRG 1351: MAJOR CHEST & RESPIRAZORY TRAUMA

Facility IP

$7,558.97

Service Code	APR-DRG 1351
Hospital Charge Code	APRDRG 1351
Min. Negotiated Rate	$1,717.63
Max. Negotiated Rate	$7,558.97
Rate for Payer: Buckeye Health Medicaid OOS	$1,717.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,558.97
Rate for Payer: Managed Health Services Medicaid	$7,558.97
Rate for Payer: MDWise Medicaid	$7,558.97
Rate for Payer: Molina Healthcare of OH Medicare	$1,717.63

INPATIENT APRDRG 1352: MAJOR CHEST & RESPIRATORY TRAUMA

Facility IP

$10,955.51

Service Code	APR-DRG 1352
Hospital Charge Code	APRDRG 1352
Min. Negotiated Rate	$1,979.56
Max. Negotiated Rate	$10,955.51
Rate for Payer: Buckeye Health Medicaid OOS	$1,979.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,955.51
Rate for Payer: Managed Health Services Medicaid	$10,955.51
Rate for Payer: MDWise Medicaid	$10,955.51
Rate for Payer: Molina Healthcare of OH Medicare	$1,979.56

INPATIENT APRDRG 1353: MAJOR CHEST & RESPIRATORY TRAUMA

Facility IP

$13,311.14

Service Code	APR-DRG 1353
Hospital Charge Code	APRDRG 1353
Min. Negotiated Rate	$2,994.64
Max. Negotiated Rate	$13,311.14
Rate for Payer: Buckeye Health Medicaid OOS	$2,994.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,311.14
Rate for Payer: Managed Health Services Medicaid	$13,311.14
Rate for Payer: MDWise Medicaid	$13,311.14
Rate for Payer: Molina Healthcare of OH Medicare	$2,994.64

INPATIENT APRDRG 1354: MAJOR CHEST & RESPIRATORY TRAUMA

Facility IP

$20,765.28

Service Code	APR-DRG 1354
Hospital Charge Code	APRDRG 1354
Min. Negotiated Rate	$6,250.90
Max. Negotiated Rate	$20,765.28
Rate for Payer: Buckeye Health Medicaid OOS	$6,250.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,765.28
Rate for Payer: Managed Health Services Medicaid	$20,765.28
Rate for Payer: MDWise Medicaid	$20,765.28
Rate for Payer: Molina Healthcare of OH Medicare	$6,250.90

INPATIENT APRDRG 1361: RESPIRATORY MALIGNANCY

Facility IP

$7,048.38

Service Code	APR-DRG 1361
Hospital Charge Code	APRDRG 1361
Min. Negotiated Rate	$2,611.35
Max. Negotiated Rate	$7,048.38
Rate for Payer: Buckeye Health Medicaid OOS	$2,611.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,048.38
Rate for Payer: Managed Health Services Medicaid	$7,048.38
Rate for Payer: MDWise Medicaid	$7,048.38
Rate for Payer: Molina Healthcare of OH Medicare	$2,611.35

INPATIENT APRDRG 1362: RESPIRATORY MALIGNANCY

Facility IP

$11,690.57

Service Code	APR-DRG 1362
Hospital Charge Code	APRDRG 1362
Min. Negotiated Rate	$2,758.64
Max. Negotiated Rate	$11,690.57
Rate for Payer: Buckeye Health Medicaid OOS	$2,758.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,690.57
Rate for Payer: Managed Health Services Medicaid	$11,690.57
Rate for Payer: MDWise Medicaid	$11,690.57
Rate for Payer: Molina Healthcare of OH Medicare	$2,758.64

INPATIENT APRDRG 1363: RESPIRATORY MALIGNANCY

Facility IP

$15,929.46

Service Code	APR-DRG 1363
Hospital Charge Code	APRDRG 1363
Min. Negotiated Rate	$3,856.98
Max. Negotiated Rate	$15,929.46
Rate for Payer: Buckeye Health Medicaid OOS	$3,856.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,929.46
Rate for Payer: Managed Health Services Medicaid	$15,929.46
Rate for Payer: MDWise Medicaid	$15,929.46
Rate for Payer: Molina Healthcare of OH Medicare	$3,856.98

INPATIENT APRDRG 1364: RESPIRATORY MALIGNANCY

Facility IP

$19,633.10

Service Code	APR-DRG 1364
Hospital Charge Code	APRDRG 1364
Min. Negotiated Rate	$6,316.22
Max. Negotiated Rate	$19,633.10
Rate for Payer: Buckeye Health Medicaid OOS	$6,316.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,633.10
Rate for Payer: Managed Health Services Medicaid	$19,633.10
Rate for Payer: MDWise Medicaid	$19,633.10
Rate for Payer: Molina Healthcare of OH Medicare	$6,316.22

INPATIENT APRDRG 1371: MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS

Facility IP

$8,718.29

Service Code	APR-DRG 1371
Hospital Charge Code	APRDRG 1371
Min. Negotiated Rate	$2,013.83
Max. Negotiated Rate	$8,718.29
Rate for Payer: Buckeye Health Medicaid OOS	$2,013.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,718.29
Rate for Payer: Managed Health Services Medicaid	$8,718.29
Rate for Payer: MDWise Medicaid	$8,718.29
Rate for Payer: Molina Healthcare of OH Medicare	$2,013.83

INPATIENT APRDRG 1372: MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS

Facility IP

$12,897.98

Service Code	APR-DRG 1372
Hospital Charge Code	APRDRG 1372
Min. Negotiated Rate	$2,637.92
Max. Negotiated Rate	$12,897.98
Rate for Payer: Buckeye Health Medicaid OOS	$2,637.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,897.98
Rate for Payer: Managed Health Services Medicaid	$12,897.98
Rate for Payer: MDWise Medicaid	$12,897.98
Rate for Payer: Molina Healthcare of OH Medicare	$2,637.92

INPATIENT APRDRG 1373: MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS

Facility IP

$16,855.68

Service Code	APR-DRG 1373
Hospital Charge Code	APRDRG 1373
Min. Negotiated Rate	$3,834.24
Max. Negotiated Rate	$16,855.68
Rate for Payer: Buckeye Health Medicaid OOS	$3,834.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,855.68
Rate for Payer: Managed Health Services Medicaid	$16,855.68
Rate for Payer: MDWise Medicaid	$16,855.68
Rate for Payer: Molina Healthcare of OH Medicare	$3,834.24

INPATIENT APRDRG 1374: MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS

Facility IP

$29,874.53

Service Code	APR-DRG 1374
Hospital Charge Code	APRDRG 1374
Min. Negotiated Rate	$6,649.56
Max. Negotiated Rate	$29,874.53
Rate for Payer: Buckeye Health Medicaid OOS	$6,649.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$29,874.53
Rate for Payer: Managed Health Services Medicaid	$29,874.53
Rate for Payer: MDWise Medicaid	$29,874.53
Rate for Payer: Molina Healthcare of OH Medicare	$6,649.56

INPATIENT APRDRG 1381: BRONCHIOLITIS & RSV PNEUMONIA

Facility IP

$6,002.53

Service Code	APR-DRG 1381
Hospital Charge Code	APRDRG 1381
Min. Negotiated Rate	$1,840.91
Max. Negotiated Rate	$6,002.53
Rate for Payer: Buckeye Health Medicaid OOS	$1,840.91
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,002.53
Rate for Payer: Managed Health Services Medicaid	$6,002.53
Rate for Payer: MDWise Medicaid	$6,002.53
Rate for Payer: Molina Healthcare of OH Medicare	$1,840.91

INPATIENT APRDRG 1382: BRONCHIOLITIS & RSV PNEUMONIA

Facility IP

$8,342.13

Service Code	APR-DRG 1382
Hospital Charge Code	APRDRG 1382
Min. Negotiated Rate	$2,703.57
Max. Negotiated Rate	$8,342.13
Rate for Payer: Buckeye Health Medicaid OOS	$2,703.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,342.13
Rate for Payer: Managed Health Services Medicaid	$8,342.13
Rate for Payer: MDWise Medicaid	$8,342.13
Rate for Payer: Molina Healthcare of OH Medicare	$2,703.57

INPATIENT APRDRG 1383: BRONCHIOLITIS & RSV PNEUMONIA

Facility IP

$11,726.34

Service Code	APR-DRG 1383
Hospital Charge Code	APRDRG 1383
Min. Negotiated Rate	$4,281.90
Max. Negotiated Rate	$11,726.34
Rate for Payer: Buckeye Health Medicaid OOS	$4,281.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,726.34
Rate for Payer: Managed Health Services Medicaid	$11,726.34
Rate for Payer: MDWise Medicaid	$11,726.34
Rate for Payer: Molina Healthcare of OH Medicare	$4,281.90

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