Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 2012: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility IP

$8,765.15

Service Code	APR-DRG 2012
Hospital Charge Code	APRDRG 2012
Min. Negotiated Rate	$1,772.06
Max. Negotiated Rate	$8,765.15
Rate for Payer: Buckeye Health Medicaid OOS	$1,772.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,765.15
Rate for Payer: Managed Health Services Medicaid	$8,765.15
Rate for Payer: MDWise Medicaid	$8,765.15
Rate for Payer: Molina Healthcare of OH Medicare	$1,772.06

INPATIENT APRDRG 2013: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility IP

$13,628.10

Service Code	APR-DRG 2013
Hospital Charge Code	APRDRG 2013
Min. Negotiated Rate	$2,553.39
Max. Negotiated Rate	$13,628.10
Rate for Payer: Buckeye Health Medicaid OOS	$2,553.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,628.10
Rate for Payer: Managed Health Services Medicaid	$13,628.10
Rate for Payer: MDWise Medicaid	$13,628.10
Rate for Payer: Molina Healthcare of OH Medicare	$2,553.39

INPATIENT APRDRG 2014: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility IP

$17,257.74

Service Code	APR-DRG 2014
Hospital Charge Code	APRDRG 2014
Min. Negotiated Rate	$5,467.01
Max. Negotiated Rate	$17,257.74
Rate for Payer: Buckeye Health Medicaid OOS	$5,467.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,257.74
Rate for Payer: Managed Health Services Medicaid	$17,257.74
Rate for Payer: MDWise Medicaid	$17,257.74
Rate for Payer: Molina Healthcare of OH Medicare	$5,467.01

INPATIENT APRDRG 2031: CHEST PAIN

Facility IP

$6,635.22

Service Code	APR-DRG 2031
Hospital Charge Code	APRDRG 2031
Min. Negotiated Rate	$1,342.66
Max. Negotiated Rate	$6,635.22
Rate for Payer: Buckeye Health Medicaid OOS	$1,342.66
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,635.22
Rate for Payer: Managed Health Services Medicaid	$6,635.22
Rate for Payer: MDWise Medicaid	$6,635.22
Rate for Payer: Molina Healthcare of OH Medicare	$1,342.66

INPATIENT APRDRG 2032: CHEST PAIN

Facility IP

$7,836.47

Service Code	APR-DRG 2032
Hospital Charge Code	APRDRG 2032
Min. Negotiated Rate	$1,665.43
Max. Negotiated Rate	$7,836.47
Rate for Payer: Buckeye Health Medicaid OOS	$1,665.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,836.47
Rate for Payer: Managed Health Services Medicaid	$7,836.47
Rate for Payer: MDWise Medicaid	$7,836.47
Rate for Payer: Molina Healthcare of OH Medicare	$1,665.43

INPATIENT APRDRG 2033: CHEST PAIN

Facility IP

$10,394.36

Service Code	APR-DRG 2033
Hospital Charge Code	APRDRG 2033
Min. Negotiated Rate	$1,962.59
Max. Negotiated Rate	$10,394.36
Rate for Payer: Buckeye Health Medicaid OOS	$1,962.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,394.36
Rate for Payer: Managed Health Services Medicaid	$10,394.36
Rate for Payer: MDWise Medicaid	$10,394.36
Rate for Payer: Molina Healthcare of OH Medicare	$1,962.59

INPATIENT APRDRG 2034: CHEST PAIN

Facility IP

$10,394.36

Service Code	APR-DRG 2034
Hospital Charge Code	APRDRG 2034
Min. Negotiated Rate	$1,962.59
Max. Negotiated Rate	$10,394.36
Rate for Payer: Buckeye Health Medicaid OOS	$1,962.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,394.36
Rate for Payer: Managed Health Services Medicaid	$10,394.36
Rate for Payer: MDWise Medicaid	$10,394.36
Rate for Payer: Molina Healthcare of OH Medicare	$1,962.59

INPATIENT APRDRG 2041: SYNCOPE & COLLAPSE

Facility IP

$8,313.76

Service Code	APR-DRG 2041
Hospital Charge Code	APRDRG 2041
Min. Negotiated Rate	$1,628.61
Max. Negotiated Rate	$8,313.76
Rate for Payer: Buckeye Health Medicaid OOS	$1,628.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,313.76
Rate for Payer: Managed Health Services Medicaid	$8,313.76
Rate for Payer: MDWise Medicaid	$8,313.76
Rate for Payer: Molina Healthcare of OH Medicare	$1,628.61

INPATIENT APRDRG 2042: SYNCOPE & COLLAPSE

Facility IP

$8,470.39

Service Code	APR-DRG 2042
Hospital Charge Code	APRDRG 2042
Min. Negotiated Rate	$1,812.73
Max. Negotiated Rate	$8,470.39
Rate for Payer: Buckeye Health Medicaid OOS	$1,812.73
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,470.39
Rate for Payer: Managed Health Services Medicaid	$8,470.39
Rate for Payer: MDWise Medicaid	$8,470.39
Rate for Payer: Molina Healthcare of OH Medicare	$1,812.73

INPATIENT APRDRG 2043: SYNCOPE & COLLAPSE

Facility IP

$13,333.34

Service Code	APR-DRG 2043
Hospital Charge Code	APRDRG 2043
Min. Negotiated Rate	$2,279.92
Max. Negotiated Rate	$13,333.34
Rate for Payer: Buckeye Health Medicaid OOS	$2,279.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,333.34
Rate for Payer: Managed Health Services Medicaid	$13,333.34
Rate for Payer: MDWise Medicaid	$13,333.34
Rate for Payer: Molina Healthcare of OH Medicare	$2,279.92

INPATIENT APRDRG 2044: SYNCOPE & COLLAPSE

Facility IP

$16,650.95

Service Code	APR-DRG 2044
Hospital Charge Code	APRDRG 2044
Min. Negotiated Rate	$4,131.40
Max. Negotiated Rate	$16,650.95
Rate for Payer: Buckeye Health Medicaid OOS	$4,131.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,650.95
Rate for Payer: Managed Health Services Medicaid	$16,650.95
Rate for Payer: MDWise Medicaid	$16,650.95
Rate for Payer: Molina Healthcare of OH Medicare	$4,131.40

INPATIENT APRDRG 2051: CARDIOMYOPATHY

Facility IP

$6,508.19

Service Code	APR-DRG 2051
Hospital Charge Code	APRDRG 2051
Min. Negotiated Rate	$1,652.30
Max. Negotiated Rate	$6,508.19
Rate for Payer: Buckeye Health Medicaid OOS	$1,652.30
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,508.19
Rate for Payer: Managed Health Services Medicaid	$6,508.19
Rate for Payer: MDWise Medicaid	$6,508.19
Rate for Payer: Molina Healthcare of OH Medicare	$1,652.30

INPATIENT APRDRG 2052: CARDIOMYOPATHY

Facility IP

$6,527.92

Service Code	APR-DRG 2052
Hospital Charge Code	APRDRG 2052
Min. Negotiated Rate	$1,824.26
Max. Negotiated Rate	$6,527.92
Rate for Payer: Buckeye Health Medicaid OOS	$1,824.26
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,527.92
Rate for Payer: Managed Health Services Medicaid	$6,527.92
Rate for Payer: MDWise Medicaid	$6,527.92
Rate for Payer: Molina Healthcare of OH Medicare	$1,824.26

INPATIENT APRDRG 2053: CARDIOMYOPATHY

Facility IP

$10,364.76

Service Code	APR-DRG 2053
Hospital Charge Code	APRDRG 2053
Min. Negotiated Rate	$4,303.04
Max. Negotiated Rate	$10,364.76
Rate for Payer: Buckeye Health Medicaid OOS	$4,303.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,364.76
Rate for Payer: Managed Health Services Medicaid	$10,364.76
Rate for Payer: MDWise Medicaid	$10,364.76
Rate for Payer: Molina Healthcare of OH Medicare	$4,303.04

INPATIENT APRDRG 2054: CARDIOMYOPATHY

Facility IP

$16,949.41

Service Code	APR-DRG 2054
Hospital Charge Code	APRDRG 2054
Min. Negotiated Rate	$4,303.04
Max. Negotiated Rate	$16,949.41
Rate for Payer: Buckeye Health Medicaid OOS	$4,303.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,949.41
Rate for Payer: Managed Health Services Medicaid	$16,949.41
Rate for Payer: MDWise Medicaid	$16,949.41
Rate for Payer: Molina Healthcare of OH Medicare	$4,303.04

INPATIENT APRDRG 2061: MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility IP

$7,787.14

Service Code	APR-DRG 2061
Hospital Charge Code	APRDRG 2061
Min. Negotiated Rate	$2,126.22
Max. Negotiated Rate	$7,787.14
Rate for Payer: Buckeye Health Medicaid OOS	$2,126.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,787.14
Rate for Payer: Managed Health Services Medicaid	$7,787.14
Rate for Payer: MDWise Medicaid	$7,787.14
Rate for Payer: Molina Healthcare of OH Medicare	$2,126.22

INPATIENT APRDRG 2062: MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility IP

$8,810.78

Service Code	APR-DRG 2062
Hospital Charge Code	APRDRG 2062
Min. Negotiated Rate	$1,997.49
Max. Negotiated Rate	$8,810.78
Rate for Payer: Buckeye Health Medicaid OOS	$1,997.49
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,810.78
Rate for Payer: Managed Health Services Medicaid	$8,810.78
Rate for Payer: MDWise Medicaid	$8,810.78
Rate for Payer: Molina Healthcare of OH Medicare	$1,997.49

INPATIENT APRDRG 2063: MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility IP

$14,571.59

Service Code	APR-DRG 2063
Hospital Charge Code	APRDRG 2063
Min. Negotiated Rate	$3,819.83
Max. Negotiated Rate	$14,571.59
Rate for Payer: Buckeye Health Medicaid OOS	$3,819.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,571.59
Rate for Payer: Managed Health Services Medicaid	$14,571.59
Rate for Payer: MDWise Medicaid	$14,571.59
Rate for Payer: Molina Healthcare of OH Medicare	$3,819.83

INPATIENT APRDRG 2064: MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR PROCEDURE

Facility IP

$23,842.40

Service Code	APR-DRG 2064
Hospital Charge Code	APRDRG 2064
Min. Negotiated Rate	$8,415.22
Max. Negotiated Rate	$23,842.40
Rate for Payer: Buckeye Health Medicaid OOS	$8,415.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,842.40
Rate for Payer: Managed Health Services Medicaid	$23,842.40
Rate for Payer: MDWise Medicaid	$23,842.40
Rate for Payer: Molina Healthcare of OH Medicare	$8,415.22

INPATIENT APRDRG 2071: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility IP

$7,684.77

Service Code	APR-DRG 2071
Hospital Charge Code	APRDRG 2071
Min. Negotiated Rate	$1,630.85
Max. Negotiated Rate	$7,684.77
Rate for Payer: Buckeye Health Medicaid OOS	$1,630.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,684.77
Rate for Payer: Managed Health Services Medicaid	$7,684.77
Rate for Payer: MDWise Medicaid	$7,684.77
Rate for Payer: Molina Healthcare of OH Medicare	$1,630.85

INPATIENT APRDRG 2072: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility IP

$11,657.27

Service Code	APR-DRG 2072
Hospital Charge Code	APRDRG 2072
Min. Negotiated Rate	$2,045.21
Max. Negotiated Rate	$11,657.27
Rate for Payer: Buckeye Health Medicaid OOS	$2,045.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,657.27
Rate for Payer: Managed Health Services Medicaid	$11,657.27
Rate for Payer: MDWise Medicaid	$11,657.27
Rate for Payer: Molina Healthcare of OH Medicare	$2,045.21

INPATIENT APRDRG 2073: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility IP

$19,803.30

Service Code	APR-DRG 2073
Hospital Charge Code	APRDRG 2073
Min. Negotiated Rate	$3,212.07
Max. Negotiated Rate	$19,803.30
Rate for Payer: Buckeye Health Medicaid OOS	$3,212.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,803.30
Rate for Payer: Managed Health Services Medicaid	$19,803.30
Rate for Payer: MDWise Medicaid	$19,803.30
Rate for Payer: Molina Healthcare of OH Medicare	$3,212.07

INPATIENT APRDRG 2074: OTHER CIRCULATORY SYSTEM DIAGNOSES

Facility IP

$19,803.30

Service Code	APR-DRG 2074
Hospital Charge Code	APRDRG 2074
Min. Negotiated Rate	$7,392.46
Max. Negotiated Rate	$19,803.30
Rate for Payer: Buckeye Health Medicaid OOS	$7,392.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,803.30
Rate for Payer: Managed Health Services Medicaid	$19,803.30
Rate for Payer: MDWise Medicaid	$19,803.30
Rate for Payer: Molina Healthcare of OH Medicare	$7,392.46

INPATIENT APRDRG 2201: MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility IP

$20,294.16

Service Code	APR-DRG 2201
Hospital Charge Code	APRDRG 2201
Min. Negotiated Rate	$4,985.73
Max. Negotiated Rate	$20,294.16
Rate for Payer: Buckeye Health Medicaid OOS	$4,985.73
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,294.16
Rate for Payer: Managed Health Services Medicaid	$20,294.16
Rate for Payer: MDWise Medicaid	$20,294.16
Rate for Payer: Molina Healthcare of OH Medicare	$4,985.73

INPATIENT APRDRG 2202: MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility IP

$26,174.59

Service Code	APR-DRG 2202
Hospital Charge Code	APRDRG 2202
Min. Negotiated Rate	$6,842.65
Max. Negotiated Rate	$26,174.59
Rate for Payer: Buckeye Health Medicaid OOS	$6,842.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$26,174.59
Rate for Payer: Managed Health Services Medicaid	$26,174.59
Rate for Payer: MDWise Medicaid	$26,174.59
Rate for Payer: Molina Healthcare of OH Medicare	$6,842.65

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