Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 1753: PERCUTANEOUS CORONARY INTERVENTION W/O AMI

Facility IP

$32,147.52

Service Code	APR-DRG 1753
Hospital Charge Code	APRDRG 1753
Min. Negotiated Rate	$7,493.97
Max. Negotiated Rate	$32,147.52
Rate for Payer: Buckeye Health Medicaid OOS	$7,493.97
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$32,147.52
Rate for Payer: Managed Health Services Medicaid	$32,147.52
Rate for Payer: MDWise Medicaid	$32,147.52
Rate for Payer: Molina Healthcare of OH Medicare	$7,493.97

INPATIENT APRDRG 1754: PERCUTANEOUS CORONARY INTERVENTION W/O AMI

Facility IP

$64,013.85

Service Code	APR-DRG 1754
Hospital Charge Code	APRDRG 1754
Min. Negotiated Rate	$15,134.59
Max. Negotiated Rate	$64,013.85
Rate for Payer: Buckeye Health Medicaid OOS	$15,134.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$64,013.85
Rate for Payer: Managed Health Services Medicaid	$64,013.85
Rate for Payer: MDWise Medicaid	$64,013.85
Rate for Payer: Molina Healthcare of OH Medicare	$15,134.59

INPATIENT APRDRG 1761: CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility IP

$22,748.45

Service Code	APR-DRG 1761
Hospital Charge Code	APRDRG 1761
Min. Negotiated Rate	$14,957.20
Max. Negotiated Rate	$22,748.45
Rate for Payer: Buckeye Health Medicaid OOS	$14,957.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,748.45
Rate for Payer: Managed Health Services Medicaid	$22,748.45
Rate for Payer: MDWise Medicaid	$22,748.45
Rate for Payer: Molina Healthcare of OH Medicare	$14,957.20

INPATIENT APRDRG 1762: CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility IP

$22,949.48

Service Code	APR-DRG 1762
Hospital Charge Code	APRDRG 1762
Min. Negotiated Rate	$14,957.20
Max. Negotiated Rate	$22,949.48
Rate for Payer: Buckeye Health Medicaid OOS	$14,957.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,949.48
Rate for Payer: Managed Health Services Medicaid	$22,949.48
Rate for Payer: MDWise Medicaid	$22,949.48
Rate for Payer: Molina Healthcare of OH Medicare	$14,957.20

INPATIENT APRDRG 1763: CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility IP

$66,368.25

Service Code	APR-DRG 1763
Hospital Charge Code	APRDRG 1763
Min. Negotiated Rate	$14,957.20
Max. Negotiated Rate	$66,368.25
Rate for Payer: Buckeye Health Medicaid OOS	$14,957.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$66,368.25
Rate for Payer: Managed Health Services Medicaid	$66,368.25
Rate for Payer: MDWise Medicaid	$66,368.25
Rate for Payer: Molina Healthcare of OH Medicare	$14,957.20

INPATIENT APRDRG 1764: CARDIAC PACEMAKER & DEFIBRILLATOR DEVICE REPLACEMENT

Facility IP

$66,368.25

Service Code	APR-DRG 1764
Hospital Charge Code	APRDRG 1764
Min. Negotiated Rate	$14,957.20
Max. Negotiated Rate	$66,368.25
Rate for Payer: Buckeye Health Medicaid OOS	$14,957.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$66,368.25
Rate for Payer: Managed Health Services Medicaid	$66,368.25
Rate for Payer: MDWise Medicaid	$66,368.25
Rate for Payer: Molina Healthcare of OH Medicare	$14,957.20

INPATIENT APRDRG 1771: CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility IP

$13,301.28

Service Code	APR-DRG 1771
Hospital Charge Code	APRDRG 1771
Min. Negotiated Rate	$8,444.68
Max. Negotiated Rate	$13,301.28
Rate for Payer: Buckeye Health Medicaid OOS	$8,444.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,301.28
Rate for Payer: Managed Health Services Medicaid	$13,301.28
Rate for Payer: MDWise Medicaid	$13,301.28
Rate for Payer: Molina Healthcare of OH Medicare	$8,444.68

INPATIENT APRDRG 1772: CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility IP

$21,563.24

Service Code	APR-DRG 1772
Hospital Charge Code	APRDRG 1772
Min. Negotiated Rate	$8,444.68
Max. Negotiated Rate	$21,563.24
Rate for Payer: Buckeye Health Medicaid OOS	$8,444.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,563.24
Rate for Payer: Managed Health Services Medicaid	$21,563.24
Rate for Payer: MDWise Medicaid	$21,563.24
Rate for Payer: Molina Healthcare of OH Medicare	$8,444.68

INPATIENT APRDRG 1773: CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility IP

$36,457.95

Service Code	APR-DRG 1773
Hospital Charge Code	APRDRG 1773
Min. Negotiated Rate	$8,444.68
Max. Negotiated Rate	$36,457.95
Rate for Payer: Buckeye Health Medicaid OOS	$8,444.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$36,457.95
Rate for Payer: Managed Health Services Medicaid	$36,457.95
Rate for Payer: MDWise Medicaid	$36,457.95
Rate for Payer: Molina Healthcare of OH Medicare	$8,444.68

INPATIENT APRDRG 1774: CARDIAC PACEMAKER & DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility IP

$36,457.95

Service Code	APR-DRG 1774
Hospital Charge Code	APRDRG 1774
Min. Negotiated Rate	$8,444.68
Max. Negotiated Rate	$36,457.95
Rate for Payer: Buckeye Health Medicaid OOS	$8,444.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$36,457.95
Rate for Payer: Managed Health Services Medicaid	$36,457.95
Rate for Payer: MDWise Medicaid	$36,457.95
Rate for Payer: Molina Healthcare of OH Medicare	$8,444.68

INPATIENT APRDRG 1781: EXTERNAL HEART ASSIST SYSTEMS

Facility IP

$13,818.51

Service Code	APR-DRG 1781
Hospital Charge Code	APRDRG 1781
Min. Negotiated Rate	$13,818.51
Max. Negotiated Rate	$13,818.51
Rate for Payer: Buckeye Health Medicaid OOS	$13,818.51
Rate for Payer: Molina Healthcare of OH Medicare	$13,818.51

INPATIENT APRDRG 1782: EXTERNAL HEART ASSIST SYSTEMS

Facility IP

$16,725.42

Service Code	APR-DRG 1782
Hospital Charge Code	APRDRG 1782
Min. Negotiated Rate	$16,725.42
Max. Negotiated Rate	$16,725.42
Rate for Payer: Buckeye Health Medicaid OOS	$16,725.42
Rate for Payer: Molina Healthcare of OH Medicare	$16,725.42

INPATIENT APRDRG 1783: EXTERNAL HEART ASSIST SYSTEMS

Facility IP

$28,580.70

Service Code	APR-DRG 1783
Hospital Charge Code	APRDRG 1783
Min. Negotiated Rate	$28,580.70
Max. Negotiated Rate	$28,580.70
Rate for Payer: Buckeye Health Medicaid OOS	$28,580.70
Rate for Payer: Molina Healthcare of OH Medicare	$28,580.70

INPATIENT APRDRG 1784: EXTERNAL HEART ASSIST SYSTEMS

Facility IP

$53,895.22

Service Code	APR-DRG 1784
Hospital Charge Code	APRDRG 1784
Min. Negotiated Rate	$53,895.22
Max. Negotiated Rate	$53,895.22
Rate for Payer: Buckeye Health Medicaid OOS	$53,895.22
Rate for Payer: Molina Healthcare of OH Medicare	$53,895.22

INPATIENT APRDRG 1791: DEFIBRILLATOR IMPLANTS

Facility IP

$13,818.51

Service Code	APR-DRG 1791
Hospital Charge Code	APRDRG 1791
Min. Negotiated Rate	$13,818.51
Max. Negotiated Rate	$13,818.51
Rate for Payer: Buckeye Health Medicaid OOS	$13,818.51
Rate for Payer: Molina Healthcare of OH Medicare	$13,818.51

INPATIENT APRDRG 1792: DEFIBRILLATOR IMPLANTS

Facility IP

$16,725.42

Service Code	APR-DRG 1792
Hospital Charge Code	APRDRG 1792
Min. Negotiated Rate	$16,725.42
Max. Negotiated Rate	$16,725.42
Rate for Payer: Buckeye Health Medicaid OOS	$16,725.42
Rate for Payer: Molina Healthcare of OH Medicare	$16,725.42

INPATIENT APRDRG 1793: DEFIBRILLATOR IMPLANTS

Facility IP

$28,580.70

Service Code	APR-DRG 1793
Hospital Charge Code	APRDRG 1793
Min. Negotiated Rate	$28,580.70
Max. Negotiated Rate	$28,580.70
Rate for Payer: Buckeye Health Medicaid OOS	$28,580.70
Rate for Payer: Molina Healthcare of OH Medicare	$28,580.70

INPATIENT APRDRG 1794: DEFIBRILLATOR IMPLANTS

Facility IP

$53,895.22

Service Code	APR-DRG 1794
Hospital Charge Code	APRDRG 1794
Min. Negotiated Rate	$53,895.22
Max. Negotiated Rate	$53,895.22
Rate for Payer: Buckeye Health Medicaid OOS	$53,895.22
Rate for Payer: Molina Healthcare of OH Medicare	$53,895.22

INPATIENT APRDRG 1801: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility IP

$14,907.05

Service Code	APR-DRG 1801
Hospital Charge Code	APRDRG 1801
Min. Negotiated Rate	$3,705.20
Max. Negotiated Rate	$14,907.05
Rate for Payer: Buckeye Health Medicaid OOS	$3,705.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,907.05
Rate for Payer: Managed Health Services Medicaid	$14,907.05
Rate for Payer: MDWise Medicaid	$14,907.05
Rate for Payer: Molina Healthcare of OH Medicare	$3,705.20

INPATIENT APRDRG 1802: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility IP

$18,351.69

Service Code	APR-DRG 1802
Hospital Charge Code	APRDRG 1802
Min. Negotiated Rate	$4,681.21
Max. Negotiated Rate	$18,351.69
Rate for Payer: Buckeye Health Medicaid OOS	$4,681.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,351.69
Rate for Payer: Managed Health Services Medicaid	$18,351.69
Rate for Payer: MDWise Medicaid	$18,351.69
Rate for Payer: Molina Healthcare of OH Medicare	$4,681.21

INPATIENT APRDRG 1803: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility IP

$29,346.67

Service Code	APR-DRG 1803
Hospital Charge Code	APRDRG 1803
Min. Negotiated Rate	$6,924.95
Max. Negotiated Rate	$29,346.67
Rate for Payer: Buckeye Health Medicaid OOS	$6,924.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$29,346.67
Rate for Payer: Managed Health Services Medicaid	$29,346.67
Rate for Payer: MDWise Medicaid	$29,346.67
Rate for Payer: Molina Healthcare of OH Medicare	$6,924.95

INPATIENT APRDRG 1804: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility IP

$38,669.28

Service Code	APR-DRG 1804
Hospital Charge Code	APRDRG 1804
Min. Negotiated Rate	$15,404.86
Max. Negotiated Rate	$38,669.28
Rate for Payer: Buckeye Health Medicaid OOS	$15,404.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$38,669.28
Rate for Payer: Managed Health Services Medicaid	$38,669.28
Rate for Payer: MDWise Medicaid	$38,669.28
Rate for Payer: Molina Healthcare of OH Medicare	$15,404.86

INPATIENT APRDRG 1811: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility IP

$23,499.54

Service Code	APR-DRG 1811
Hospital Charge Code	APRDRG 1811
Min. Negotiated Rate	$5,378.31
Max. Negotiated Rate	$23,499.54
Rate for Payer: Buckeye Health Medicaid OOS	$5,378.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,499.54
Rate for Payer: Managed Health Services Medicaid	$23,499.54
Rate for Payer: MDWise Medicaid	$23,499.54
Rate for Payer: Molina Healthcare of OH Medicare	$5,378.31

INPATIENT APRDRG 1812: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility IP

$31,250.91

Service Code	APR-DRG 1812
Hospital Charge Code	APRDRG 1812
Min. Negotiated Rate	$7,328.74
Max. Negotiated Rate	$31,250.91
Rate for Payer: Buckeye Health Medicaid OOS	$7,328.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$31,250.91
Rate for Payer: Managed Health Services Medicaid	$31,250.91
Rate for Payer: MDWise Medicaid	$31,250.91
Rate for Payer: Molina Healthcare of OH Medicare	$7,328.74

INPATIENT APRDRG 1813: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility IP

$49,610.00

Service Code	APR-DRG 1813
Hospital Charge Code	APRDRG 1813
Min. Negotiated Rate	$10,505.58
Max. Negotiated Rate	$49,610.00
Rate for Payer: Buckeye Health Medicaid OOS	$10,505.58
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$49,610.00
Rate for Payer: Managed Health Services Medicaid	$49,610.00
Rate for Payer: MDWise Medicaid	$49,610.00
Rate for Payer: Molina Healthcare of OH Medicare	$10,505.58

Price Transparency.

All Charges