Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 2203: MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility IP

$48,578.95

Service Code	APR-DRG 2203
Hospital Charge Code	APRDRG 2203
Min. Negotiated Rate	$10,396.07
Max. Negotiated Rate	$48,578.95
Rate for Payer: Buckeye Health Medicaid OOS	$10,396.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$48,578.95
Rate for Payer: Managed Health Services Medicaid	$48,578.95
Rate for Payer: MDWise Medicaid	$48,578.95
Rate for Payer: Molina Healthcare of OH Medicare	$10,396.07

INPATIENT APRDRG 2204: MAJOR STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility IP

$69,292.43

Service Code	APR-DRG 2204
Hospital Charge Code	APRDRG 2204
Min. Negotiated Rate	$19,527.93
Max. Negotiated Rate	$69,292.43
Rate for Payer: Buckeye Health Medicaid OOS	$19,527.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$69,292.43
Rate for Payer: Managed Health Services Medicaid	$69,292.43
Rate for Payer: MDWise Medicaid	$69,292.43
Rate for Payer: Molina Healthcare of OH Medicare	$19,527.93

INPATIENT APRDRG 2221: OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility IP

$6,604.39

Service Code	APR-DRG 2221
Hospital Charge Code	APRDRG 2221
Min. Negotiated Rate	$3,021.54
Max. Negotiated Rate	$6,604.39
Rate for Payer: Buckeye Health Medicaid OOS	$3,021.54
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,604.39
Rate for Payer: Managed Health Services Medicaid	$6,604.39
Rate for Payer: MDWise Medicaid	$6,604.39
Rate for Payer: Molina Healthcare of OH Medicare	$3,021.54

INPATIENT APRDRG 2222: OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility IP

$17,182.51

Service Code	APR-DRG 2222
Hospital Charge Code	APRDRG 2222
Min. Negotiated Rate	$4,668.08
Max. Negotiated Rate	$17,182.51
Rate for Payer: Buckeye Health Medicaid OOS	$4,668.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,182.51
Rate for Payer: Managed Health Services Medicaid	$17,182.51
Rate for Payer: MDWise Medicaid	$17,182.51
Rate for Payer: Molina Healthcare of OH Medicare	$4,668.08

INPATIENT APRDRG 2223: OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility IP

$25,554.24

Service Code	APR-DRG 2223
Hospital Charge Code	APRDRG 2223
Min. Negotiated Rate	$8,099.81
Max. Negotiated Rate	$25,554.24
Rate for Payer: Buckeye Health Medicaid OOS	$8,099.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,554.24
Rate for Payer: Managed Health Services Medicaid	$25,554.24
Rate for Payer: MDWise Medicaid	$25,554.24
Rate for Payer: Molina Healthcare of OH Medicare	$8,099.81

INPATIENT APRDRG 2224: OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES

Facility IP

$40,288.62

Service Code	APR-DRG 2224
Hospital Charge Code	APRDRG 2224
Min. Negotiated Rate	$12,722.74
Max. Negotiated Rate	$40,288.62
Rate for Payer: Buckeye Health Medicaid OOS	$12,722.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$40,288.62
Rate for Payer: Managed Health Services Medicaid	$40,288.62
Rate for Payer: MDWise Medicaid	$40,288.62
Rate for Payer: Molina Healthcare of OH Medicare	$12,722.74

INPATIENT APRDRG 2231: OTHER SMALL & LARGE BOWEL PROCEDURES

Facility IP

$17,249.11

Service Code	APR-DRG 2231
Hospital Charge Code	APRDRG 2231
Min. Negotiated Rate	$3,399.07
Max. Negotiated Rate	$17,249.11
Rate for Payer: Buckeye Health Medicaid OOS	$3,399.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,249.11
Rate for Payer: Managed Health Services Medicaid	$17,249.11
Rate for Payer: MDWise Medicaid	$17,249.11
Rate for Payer: Molina Healthcare of OH Medicare	$3,399.07

INPATIENT APRDRG 2232: OTHER SMALL & LARGE BOWEL PROCEDURES

Facility IP

$21,673.00

Service Code	APR-DRG 2232
Hospital Charge Code	APRDRG 2232
Min. Negotiated Rate	$5,167.93
Max. Negotiated Rate	$21,673.00
Rate for Payer: Buckeye Health Medicaid OOS	$5,167.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,673.00
Rate for Payer: Managed Health Services Medicaid	$21,673.00
Rate for Payer: MDWise Medicaid	$21,673.00
Rate for Payer: Molina Healthcare of OH Medicare	$5,167.93

INPATIENT APRDRG 2233: OTHER SMALL & LARGE BOWEL PROCEDURES

Facility IP

$22,712.68

Service Code	APR-DRG 2233
Hospital Charge Code	APRDRG 2233
Min. Negotiated Rate	$7,502.61
Max. Negotiated Rate	$22,712.68
Rate for Payer: Buckeye Health Medicaid OOS	$7,502.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,712.68
Rate for Payer: Managed Health Services Medicaid	$22,712.68
Rate for Payer: MDWise Medicaid	$22,712.68
Rate for Payer: Molina Healthcare of OH Medicare	$7,502.61

INPATIENT APRDRG 2234: OTHER SMALL & LARGE BOWEL PROCEDURES

Facility IP

$38,072.36

Service Code	APR-DRG 2234
Hospital Charge Code	APRDRG 2234
Min. Negotiated Rate	$15,225.86
Max. Negotiated Rate	$38,072.36
Rate for Payer: Buckeye Health Medicaid OOS	$15,225.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$38,072.36
Rate for Payer: Managed Health Services Medicaid	$38,072.36
Rate for Payer: MDWise Medicaid	$38,072.36
Rate for Payer: Molina Healthcare of OH Medicare	$15,225.86

INPATIENT APRDRG 2241: PERITONEAL ADHESIOLYSIS

Facility IP

$22,072.59

Service Code	APR-DRG 2241
Hospital Charge Code	APRDRG 2241
Min. Negotiated Rate	$4,068.32
Max. Negotiated Rate	$22,072.59
Rate for Payer: Buckeye Health Medicaid OOS	$4,068.32
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,072.59
Rate for Payer: Managed Health Services Medicaid	$22,072.59
Rate for Payer: MDWise Medicaid	$22,072.59
Rate for Payer: Molina Healthcare of OH Medicare	$4,068.32

INPATIENT APRDRG 2242: PERITONEAL ADHESIOLYSIS

Facility IP

$29,388.60

Service Code	APR-DRG 2242
Hospital Charge Code	APRDRG 2242
Min. Negotiated Rate	$5,022.24
Max. Negotiated Rate	$29,388.60
Rate for Payer: Buckeye Health Medicaid OOS	$5,022.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$29,388.60
Rate for Payer: Managed Health Services Medicaid	$29,388.60
Rate for Payer: MDWise Medicaid	$29,388.60
Rate for Payer: Molina Healthcare of OH Medicare	$5,022.24

INPATIENT APRDRG 2243: PERITONEAL ADHESIOLYSIS

Facility IP

$33,141.57

Service Code	APR-DRG 2243
Hospital Charge Code	APRDRG 2243
Min. Negotiated Rate	$7,850.69
Max. Negotiated Rate	$33,141.57
Rate for Payer: Buckeye Health Medicaid OOS	$7,850.69
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$33,141.57
Rate for Payer: Managed Health Services Medicaid	$33,141.57
Rate for Payer: MDWise Medicaid	$33,141.57
Rate for Payer: Molina Healthcare of OH Medicare	$7,850.69

INPATIENT APRDRG 2244: PERITONEAL ADHESIOLYSIS

Facility IP

$49,627.26

Service Code	APR-DRG 2244
Hospital Charge Code	APRDRG 2244
Min. Negotiated Rate	$15,445.84
Max. Negotiated Rate	$49,627.26
Rate for Payer: Buckeye Health Medicaid OOS	$15,445.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$49,627.26
Rate for Payer: Managed Health Services Medicaid	$49,627.26
Rate for Payer: MDWise Medicaid	$49,627.26
Rate for Payer: Molina Healthcare of OH Medicare	$15,445.84

INPATIENT APRDRG 2261: ANAL PROCEDURES

Facility IP

$13,974.66

Service Code	APR-DRG 2261
Hospital Charge Code	APRDRG 2261
Min. Negotiated Rate	$2,774.65
Max. Negotiated Rate	$13,974.66
Rate for Payer: Buckeye Health Medicaid OOS	$2,774.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,974.66
Rate for Payer: Managed Health Services Medicaid	$13,974.66
Rate for Payer: MDWise Medicaid	$13,974.66
Rate for Payer: Molina Healthcare of OH Medicare	$2,774.65

INPATIENT APRDRG 2262: ANAL PROCEDURES

Facility IP

$13,974.66

Service Code	APR-DRG 2262
Hospital Charge Code	APRDRG 2262
Min. Negotiated Rate	$4,732.44
Max. Negotiated Rate	$13,974.66
Rate for Payer: Buckeye Health Medicaid OOS	$4,732.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,974.66
Rate for Payer: Managed Health Services Medicaid	$13,974.66
Rate for Payer: MDWise Medicaid	$13,974.66
Rate for Payer: Molina Healthcare of OH Medicare	$4,732.44

INPATIENT APRDRG 2263: ANAL PROCEDURES

Facility IP

$15,439.84

Service Code	APR-DRG 2263
Hospital Charge Code	APRDRG 2263
Min. Negotiated Rate	$4,732.44
Max. Negotiated Rate	$15,439.84
Rate for Payer: Buckeye Health Medicaid OOS	$4,732.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,439.84
Rate for Payer: Managed Health Services Medicaid	$15,439.84
Rate for Payer: MDWise Medicaid	$15,439.84
Rate for Payer: Molina Healthcare of OH Medicare	$4,732.44

INPATIENT APRDRG 2264: ANAL PROCEDURES

Facility IP

$18,640.29

Service Code	APR-DRG 2264
Hospital Charge Code	APRDRG 2264
Min. Negotiated Rate	$4,732.44
Max. Negotiated Rate	$18,640.29
Rate for Payer: Buckeye Health Medicaid OOS	$4,732.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,640.29
Rate for Payer: Managed Health Services Medicaid	$18,640.29
Rate for Payer: MDWise Medicaid	$18,640.29
Rate for Payer: Molina Healthcare of OH Medicare	$4,732.44

INPATIENT APRDRG 2271: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL

Facility IP

$17,175.11

Service Code	APR-DRG 2271
Hospital Charge Code	APRDRG 2271
Min. Negotiated Rate	$3,670.29
Max. Negotiated Rate	$17,175.11
Rate for Payer: Buckeye Health Medicaid OOS	$3,670.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,175.11
Rate for Payer: Managed Health Services Medicaid	$17,175.11
Rate for Payer: MDWise Medicaid	$17,175.11
Rate for Payer: Molina Healthcare of OH Medicare	$3,670.29

INPATIENT APRDRG 2272: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL

Facility IP

$22,845.88

Service Code	APR-DRG 2272
Hospital Charge Code	APRDRG 2272
Min. Negotiated Rate	$4,410.95
Max. Negotiated Rate	$22,845.88
Rate for Payer: Buckeye Health Medicaid OOS	$4,410.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,845.88
Rate for Payer: Managed Health Services Medicaid	$22,845.88
Rate for Payer: MDWise Medicaid	$22,845.88
Rate for Payer: Molina Healthcare of OH Medicare	$4,410.95

INPATIENT APRDRG 2273: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL

Facility IP

$27,668.13

Service Code	APR-DRG 2273
Hospital Charge Code	APRDRG 2273
Min. Negotiated Rate	$6,177.25
Max. Negotiated Rate	$27,668.13
Rate for Payer: Buckeye Health Medicaid OOS	$6,177.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$27,668.13
Rate for Payer: Managed Health Services Medicaid	$27,668.13
Rate for Payer: MDWise Medicaid	$27,668.13
Rate for Payer: Molina Healthcare of OH Medicare	$6,177.25

INPATIENT APRDRG 2274: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL

Facility IP

$46,906.57

Service Code	APR-DRG 2274
Hospital Charge Code	APRDRG 2274
Min. Negotiated Rate	$13,401.92
Max. Negotiated Rate	$46,906.57
Rate for Payer: Buckeye Health Medicaid OOS	$13,401.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$46,906.57
Rate for Payer: Managed Health Services Medicaid	$46,906.57
Rate for Payer: MDWise Medicaid	$46,906.57
Rate for Payer: Molina Healthcare of OH Medicare	$13,401.92

INPATIENT APRDRG 2281: INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES

Facility IP

$11,788.00

Service Code	APR-DRG 2281
Hospital Charge Code	APRDRG 2281
Min. Negotiated Rate	$2,768.25
Max. Negotiated Rate	$11,788.00
Rate for Payer: Buckeye Health Medicaid OOS	$2,768.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,788.00
Rate for Payer: Managed Health Services Medicaid	$11,788.00
Rate for Payer: MDWise Medicaid	$11,788.00
Rate for Payer: Molina Healthcare of OH Medicare	$2,768.25

INPATIENT APRDRG 2282: INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES

Facility IP

$16,897.61

Service Code	APR-DRG 2282
Hospital Charge Code	APRDRG 2282
Min. Negotiated Rate	$3,284.76
Max. Negotiated Rate	$16,897.61
Rate for Payer: Buckeye Health Medicaid OOS	$3,284.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,897.61
Rate for Payer: Managed Health Services Medicaid	$16,897.61
Rate for Payer: MDWise Medicaid	$16,897.61
Rate for Payer: Molina Healthcare of OH Medicare	$3,284.76

INPATIENT APRDRG 2283: INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES

Facility IP

$17,378.61

Service Code	APR-DRG 2283
Hospital Charge Code	APRDRG 2283
Min. Negotiated Rate	$5,528.81
Max. Negotiated Rate	$17,378.61
Rate for Payer: Buckeye Health Medicaid OOS	$5,528.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,378.61
Rate for Payer: Managed Health Services Medicaid	$17,378.61
Rate for Payer: MDWise Medicaid	$17,378.61
Rate for Payer: Molina Healthcare of OH Medicare	$5,528.81

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