Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 1451: ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility IP

$6,920.12

Service Code	APR-DRG 1451
Hospital Charge Code	APRDRG 1451
Min. Negotiated Rate	$1,433.92
Max. Negotiated Rate	$6,920.12
Rate for Payer: Buckeye Health Medicaid OOS	$1,433.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,920.12
Rate for Payer: Managed Health Services Medicaid	$6,920.12
Rate for Payer: MDWise Medicaid	$6,920.12
Rate for Payer: Molina Healthcare of OH Medicare	$1,433.92

INPATIENT APRDRG 1452: ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility IP

$8,063.40

Service Code	APR-DRG 1452
Hospital Charge Code	APRDRG 1452
Min. Negotiated Rate	$1,979.56
Max. Negotiated Rate	$8,063.40
Rate for Payer: Buckeye Health Medicaid OOS	$1,979.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,063.40
Rate for Payer: Managed Health Services Medicaid	$8,063.40
Rate for Payer: MDWise Medicaid	$8,063.40
Rate for Payer: Molina Healthcare of OH Medicare	$1,979.56

INPATIENT APRDRG 1453: ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility IP

$11,362.51

Service Code	APR-DRG 1453
Hospital Charge Code	APRDRG 1453
Min. Negotiated Rate	$2,977.67
Max. Negotiated Rate	$11,362.51
Rate for Payer: Buckeye Health Medicaid OOS	$2,977.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,362.51
Rate for Payer: Managed Health Services Medicaid	$11,362.51
Rate for Payer: MDWise Medicaid	$11,362.51
Rate for Payer: Molina Healthcare of OH Medicare	$2,977.67

INPATIENT APRDRG 1454: ACUTE BRONCHITIS AND RELATED SYMPTOMS

Facility IP

$15,753.10

Service Code	APR-DRG 1454
Hospital Charge Code	APRDRG 1454
Min. Negotiated Rate	$6,503.55
Max. Negotiated Rate	$15,753.10
Rate for Payer: Buckeye Health Medicaid OOS	$6,503.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,753.10
Rate for Payer: Managed Health Services Medicaid	$15,753.10
Rate for Payer: MDWise Medicaid	$15,753.10
Rate for Payer: Molina Healthcare of OH Medicare	$6,503.55

INPATIENT APRDRG 1601: MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility IP

$34,896.58

Service Code	APR-DRG 1601
Hospital Charge Code	APRDRG 1601
Min. Negotiated Rate	$11,955.83
Max. Negotiated Rate	$34,896.58
Rate for Payer: Buckeye Health Medicaid OOS	$11,955.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,896.58
Rate for Payer: Managed Health Services Medicaid	$34,896.58
Rate for Payer: MDWise Medicaid	$34,896.58
Rate for Payer: Molina Healthcare of OH Medicare	$11,955.83

INPATIENT APRDRG 1602: MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility IP

$41,188.94

Service Code	APR-DRG 1602
Hospital Charge Code	APRDRG 1602
Min. Negotiated Rate	$12,973.47
Max. Negotiated Rate	$41,188.94
Rate for Payer: Buckeye Health Medicaid OOS	$12,973.47
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$41,188.94
Rate for Payer: Managed Health Services Medicaid	$41,188.94
Rate for Payer: MDWise Medicaid	$41,188.94
Rate for Payer: Molina Healthcare of OH Medicare	$12,973.47

INPATIENT APRDRG 1603: MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility IP

$53,773.66

Service Code	APR-DRG 1603
Hospital Charge Code	APRDRG 1603
Min. Negotiated Rate	$17,886.51
Max. Negotiated Rate	$53,773.66
Rate for Payer: Buckeye Health Medicaid OOS	$17,886.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$53,773.66
Rate for Payer: Managed Health Services Medicaid	$53,773.66
Rate for Payer: MDWise Medicaid	$53,773.66
Rate for Payer: Molina Healthcare of OH Medicare	$17,886.51

INPATIENT APRDRG 1604: MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY

Facility IP

$121,967.21

Service Code	APR-DRG 1604
Hospital Charge Code	APRDRG 1604
Min. Negotiated Rate	$30,272.39
Max. Negotiated Rate	$121,967.21
Rate for Payer: Buckeye Health Medicaid OOS	$30,272.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$121,967.21
Rate for Payer: Managed Health Services Medicaid	$121,967.21
Rate for Payer: MDWise Medicaid	$121,967.21
Rate for Payer: Molina Healthcare of OH Medicare	$30,272.39

INPATIENT APRDRG 1611: CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT

Facility IP

$54,923.11

Service Code	APR-DRG 1611
Hospital Charge Code	APRDRG 1611
Min. Negotiated Rate	$13,818.51
Max. Negotiated Rate	$54,923.11
Rate for Payer: Buckeye Health Medicaid OOS	$13,818.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$54,923.11
Rate for Payer: Managed Health Services Medicaid	$54,923.11
Rate for Payer: MDWise Medicaid	$54,923.11
Rate for Payer: Molina Healthcare of OH Medicare	$13,818.51

INPATIENT APRDRG 1612: CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT

Facility IP

$67,327.76

Service Code	APR-DRG 1612
Hospital Charge Code	APRDRG 1612
Min. Negotiated Rate	$16,725.42
Max. Negotiated Rate	$67,327.76
Rate for Payer: Buckeye Health Medicaid OOS	$16,725.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$67,327.76
Rate for Payer: Managed Health Services Medicaid	$67,327.76
Rate for Payer: MDWise Medicaid	$67,327.76
Rate for Payer: Molina Healthcare of OH Medicare	$16,725.42

INPATIENT APRDRG 1613: CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT

Facility IP

$79,063.96

Service Code	APR-DRG 1613
Hospital Charge Code	APRDRG 1613
Min. Negotiated Rate	$28,580.70
Max. Negotiated Rate	$79,063.96
Rate for Payer: Buckeye Health Medicaid OOS	$28,580.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$79,063.96
Rate for Payer: Managed Health Services Medicaid	$79,063.96
Rate for Payer: MDWise Medicaid	$79,063.96
Rate for Payer: Molina Healthcare of OH Medicare	$28,580.70

INPATIENT APRDRG 1614: CARDIAC DEFIBRILLATOR & HEART ASSIST IMPLANT

Facility IP

$334,078.46

Service Code	APR-DRG 1614
Hospital Charge Code	APRDRG 1614
Min. Negotiated Rate	$53,895.22
Max. Negotiated Rate	$334,078.46
Rate for Payer: Buckeye Health Medicaid OOS	$53,895.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$334,078.46
Rate for Payer: Managed Health Services Medicaid	$334,078.46
Rate for Payer: MDWise Medicaid	$334,078.46
Rate for Payer: Molina Healthcare of OH Medicare	$53,895.22

INPATIENT APRDRG 1621: CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility IP

$45,749.73

Service Code	APR-DRG 1621
Hospital Charge Code	APRDRG 1621
Min. Negotiated Rate	$14,237.35
Max. Negotiated Rate	$45,749.73
Rate for Payer: Buckeye Health Medicaid OOS	$14,237.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$45,749.73
Rate for Payer: Managed Health Services Medicaid	$45,749.73
Rate for Payer: MDWise Medicaid	$45,749.73
Rate for Payer: Molina Healthcare of OH Medicare	$14,237.35

INPATIENT APRDRG 1622: CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility IP

$53,222.37

Service Code	APR-DRG 1622
Hospital Charge Code	APRDRG 1622
Min. Negotiated Rate	$14,237.35
Max. Negotiated Rate	$53,222.37
Rate for Payer: Buckeye Health Medicaid OOS	$14,237.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$53,222.37
Rate for Payer: Managed Health Services Medicaid	$53,222.37
Rate for Payer: MDWise Medicaid	$53,222.37
Rate for Payer: Molina Healthcare of OH Medicare	$14,237.35

INPATIENT APRDRG 1623: CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility IP

$81,106.33

Service Code	APR-DRG 1623
Hospital Charge Code	APRDRG 1623
Min. Negotiated Rate	$20,311.81
Max. Negotiated Rate	$81,106.33
Rate for Payer: Buckeye Health Medicaid OOS	$20,311.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$81,106.33
Rate for Payer: Managed Health Services Medicaid	$81,106.33
Rate for Payer: MDWise Medicaid	$81,106.33
Rate for Payer: Molina Healthcare of OH Medicare	$20,311.81

INPATIENT APRDRG 1624: CARDIAC VALVE PROCEDURES W AMI OR COMPLEX PDX

Facility IP

$112,862.89

Service Code	APR-DRG 1624
Hospital Charge Code	APRDRG 1624
Min. Negotiated Rate	$25,405.46
Max. Negotiated Rate	$112,862.89
Rate for Payer: Buckeye Health Medicaid OOS	$25,405.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$112,862.89
Rate for Payer: Managed Health Services Medicaid	$112,862.89
Rate for Payer: MDWise Medicaid	$112,862.89
Rate for Payer: Molina Healthcare of OH Medicare	$25,405.46

INPATIENT APRDRG 1631: CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility IP

$38,951.71

Service Code	APR-DRG 1631
Hospital Charge Code	APRDRG 1631
Min. Negotiated Rate	$12,089.04
Max. Negotiated Rate	$38,951.71
Rate for Payer: Buckeye Health Medicaid OOS	$12,089.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$38,951.71
Rate for Payer: Managed Health Services Medicaid	$38,951.71
Rate for Payer: MDWise Medicaid	$38,951.71
Rate for Payer: Molina Healthcare of OH Medicare	$12,089.04

INPATIENT APRDRG 1632: CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility IP

$51,616.59

Service Code	APR-DRG 1632
Hospital Charge Code	APRDRG 1632
Min. Negotiated Rate	$12,455.68
Max. Negotiated Rate	$51,616.59
Rate for Payer: Buckeye Health Medicaid OOS	$12,455.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$51,616.59
Rate for Payer: Managed Health Services Medicaid	$51,616.59
Rate for Payer: MDWise Medicaid	$51,616.59
Rate for Payer: Molina Healthcare of OH Medicare	$12,455.68

INPATIENT APRDRG 1633: CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility IP

$57,144.30

Service Code	APR-DRG 1633
Hospital Charge Code	APRDRG 1633
Min. Negotiated Rate	$15,768.62
Max. Negotiated Rate	$57,144.30
Rate for Payer: Buckeye Health Medicaid OOS	$15,768.62
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$57,144.30
Rate for Payer: Managed Health Services Medicaid	$57,144.30
Rate for Payer: MDWise Medicaid	$57,144.30
Rate for Payer: Molina Healthcare of OH Medicare	$15,768.62

INPATIENT APRDRG 1634: CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX

Facility IP

$98,790.80

Service Code	APR-DRG 1634
Hospital Charge Code	APRDRG 1634
Min. Negotiated Rate	$25,325.41
Max. Negotiated Rate	$98,790.80
Rate for Payer: Buckeye Health Medicaid OOS	$25,325.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$98,790.80
Rate for Payer: Managed Health Services Medicaid	$98,790.80
Rate for Payer: MDWise Medicaid	$98,790.80
Rate for Payer: Molina Healthcare of OH Medicare	$25,325.41

INPATIENT APRDRG 1651: CORONARY BYPASS W AMI OR COMPLEX PDX

Facility IP

$34,368.72

Service Code	APR-DRG 1651
Hospital Charge Code	APRDRG 1651
Min. Negotiated Rate	$12,977.31
Max. Negotiated Rate	$34,368.72
Rate for Payer: Buckeye Health Medicaid OOS	$12,977.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,368.72
Rate for Payer: Managed Health Services Medicaid	$34,368.72
Rate for Payer: MDWise Medicaid	$34,368.72
Rate for Payer: Molina Healthcare of OH Medicare	$12,977.31

INPATIENT APRDRG 1652: CORONARY BYPASS W AMI OR COMPLEX PDX

Facility IP

$50,277.22

Service Code	APR-DRG 1652
Hospital Charge Code	APRDRG 1652
Min. Negotiated Rate	$12,977.31
Max. Negotiated Rate	$50,277.22
Rate for Payer: Buckeye Health Medicaid OOS	$12,977.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$50,277.22
Rate for Payer: Managed Health Services Medicaid	$50,277.22
Rate for Payer: MDWise Medicaid	$50,277.22
Rate for Payer: Molina Healthcare of OH Medicare	$12,977.31

INPATIENT APRDRG 1653: CORONARY BYPASS W AMI OR COMPLEX PDX

Facility IP

$59,454.30

Service Code	APR-DRG 1653
Hospital Charge Code	APRDRG 1653
Min. Negotiated Rate	$15,233.86
Max. Negotiated Rate	$59,454.30
Rate for Payer: Buckeye Health Medicaid OOS	$15,233.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$59,454.30
Rate for Payer: Managed Health Services Medicaid	$59,454.30
Rate for Payer: MDWise Medicaid	$59,454.30
Rate for Payer: Molina Healthcare of OH Medicare	$15,233.86

INPATIENT APRDRG 1654: CORONARY BYPASS W AMI OR COMPLEX PDX

Facility IP

$101,057.63

Service Code	APR-DRG 1654
Hospital Charge Code	APRDRG 1654
Min. Negotiated Rate	$20,944.88
Max. Negotiated Rate	$101,057.63
Rate for Payer: Buckeye Health Medicaid OOS	$20,944.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$101,057.63
Rate for Payer: Managed Health Services Medicaid	$101,057.63
Rate for Payer: MDWise Medicaid	$101,057.63
Rate for Payer: Molina Healthcare of OH Medicare	$20,944.88

INPATIENT APRDRG 1661: CORONARY BYPASS W/O AMI OR COMPLEX PDX

Facility IP

$34,135.62

Service Code	APR-DRG 1661
Hospital Charge Code	APRDRG 1661
Min. Negotiated Rate	$9,117.13
Max. Negotiated Rate	$34,135.62
Rate for Payer: Buckeye Health Medicaid OOS	$9,117.13
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,135.62
Rate for Payer: Managed Health Services Medicaid	$34,135.62
Rate for Payer: MDWise Medicaid	$34,135.62
Rate for Payer: Molina Healthcare of OH Medicare	$9,117.13

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