Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

Inpatient APRDRG 3021: CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP

Facility

$26,046.33

Service Code	APR-DRG 3021
Hospital Charge Code	APRDRG 3021
Min. Negotiated Rate	$26,046.33
Max. Negotiated Rate	$26,046.33
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$26,046.33
Rate for Payer: Managed Health Services Medicaid	$26,046.33
Rate for Payer: MDWise Medicaid	$26,046.33

Inpatient APRDRG 3022: CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP

Facility

$26,479.22

Service Code	APR-DRG 3022
Hospital Charge Code	APRDRG 3022
Min. Negotiated Rate	$26,479.22
Max. Negotiated Rate	$26,479.22
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$26,479.22
Rate for Payer: Managed Health Services Medicaid	$26,479.22
Rate for Payer: MDWise Medicaid	$26,479.22

Inpatient APRDRG 3023: CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP

Facility

$37,439.67

Service Code	APR-DRG 3023
Hospital Charge Code	APRDRG 3023
Min. Negotiated Rate	$37,439.67
Max. Negotiated Rate	$37,439.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$37,439.67
Rate for Payer: Managed Health Services Medicaid	$37,439.67
Rate for Payer: MDWise Medicaid	$37,439.67

Inpatient APRDRG 3024: CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DECOMP

Facility

$37,442.13

Service Code	APR-DRG 3024
Hospital Charge Code	APRDRG 3024
Min. Negotiated Rate	$37,442.13
Max. Negotiated Rate	$37,442.13
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$37,442.13
Rate for Payer: Managed Health Services Medicaid	$37,442.13
Rate for Payer: MDWise Medicaid	$37,442.13

INPATIENT APRDRG 3031: DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK

Facility

$98,520.70

Service Code	APR-DRG 3031
Hospital Charge Code	APRDRG 3031
Min. Negotiated Rate	$17,378.97
Max. Negotiated Rate	$98,520.70
Rate for Payer: Buckeye Health Medicaid OOS	$17,378.97
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$98,520.70
Rate for Payer: Managed Health Services Medicaid	$98,520.70
Rate for Payer: MDWise Medicaid	$98,520.70
Rate for Payer: Molina Healthcare of OH Medicare	$17,378.97

INPATIENT APRDRG 3032: DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK

Facility

$98,520.70

Service Code	APR-DRG 3032
Hospital Charge Code	APRDRG 3032
Min. Negotiated Rate	$17,612.41
Max. Negotiated Rate	$98,520.70
Rate for Payer: Buckeye Health Medicaid OOS	$17,612.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$98,520.70
Rate for Payer: Managed Health Services Medicaid	$98,520.70
Rate for Payer: MDWise Medicaid	$98,520.70
Rate for Payer: Molina Healthcare of OH Medicare	$17,612.41

INPATIENT APRDRG 3033: DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK

Facility

$98,520.70

Service Code	APR-DRG 3033
Hospital Charge Code	APRDRG 3033
Min. Negotiated Rate	$24,867.18
Max. Negotiated Rate	$98,520.70
Rate for Payer: Buckeye Health Medicaid OOS	$24,867.18
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$98,520.70
Rate for Payer: Managed Health Services Medicaid	$98,520.70
Rate for Payer: MDWise Medicaid	$98,520.70
Rate for Payer: Molina Healthcare of OH Medicare	$24,867.18

INPATIENT APRDRG 3034: DORSAL & LUMBAR FUSION PROC FOR CURVATURE OF BACK

Facility

$121,471.41

Service Code	APR-DRG 3034
Hospital Charge Code	APRDRG 3034
Min. Negotiated Rate	$41,875.35
Max. Negotiated Rate	$121,471.41
Rate for Payer: Buckeye Health Medicaid OOS	$41,875.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$121,471.41
Rate for Payer: Managed Health Services Medicaid	$121,471.41
Rate for Payer: MDWise Medicaid	$121,471.41
Rate for Payer: Molina Healthcare of OH Medicare	$41,875.35

INPATIENT APRDRG 3041: DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK

Facility

$45,494.43

Service Code	APR-DRG 3041
Hospital Charge Code	APRDRG 3041
Min. Negotiated Rate	$9,927.59
Max. Negotiated Rate	$45,494.43
Rate for Payer: Buckeye Health Medicaid OOS	$9,927.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$45,494.43
Rate for Payer: Managed Health Services Medicaid	$45,494.43
Rate for Payer: MDWise Medicaid	$45,494.43
Rate for Payer: Molina Healthcare of OH Medicare	$9,927.59

INPATIENT APRDRG 3042: DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK

Facility

$53,808.19

Service Code	APR-DRG 3042
Hospital Charge Code	APRDRG 3042
Min. Negotiated Rate	$10,815.87
Max. Negotiated Rate	$53,808.19
Rate for Payer: Buckeye Health Medicaid OOS	$10,815.87
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$53,808.19
Rate for Payer: Managed Health Services Medicaid	$53,808.19
Rate for Payer: MDWise Medicaid	$53,808.19
Rate for Payer: Molina Healthcare of OH Medicare	$10,815.87

INPATIENT APRDRG 3043: DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK

Facility

$71,609.82

Service Code	APR-DRG 3043
Hospital Charge Code	APRDRG 3043
Min. Negotiated Rate	$15,421.83
Max. Negotiated Rate	$71,609.82
Rate for Payer: Buckeye Health Medicaid OOS	$15,421.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$71,609.82
Rate for Payer: Managed Health Services Medicaid	$71,609.82
Rate for Payer: MDWise Medicaid	$71,609.82
Rate for Payer: Molina Healthcare of OH Medicare	$15,421.83

INPATIENT APRDRG 3044: DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK

Facility

$81,557.72

Service Code	APR-DRG 3044
Hospital Charge Code	APRDRG 3044
Min. Negotiated Rate	$22,249.11
Max. Negotiated Rate	$81,557.72
Rate for Payer: Buckeye Health Medicaid OOS	$22,249.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$81,557.72
Rate for Payer: Managed Health Services Medicaid	$81,557.72
Rate for Payer: MDWise Medicaid	$81,557.72
Rate for Payer: Molina Healthcare of OH Medicare	$22,249.11

INPATIENT APRDRG 3051: AMPUTATION OF LOWER LIMB EXCEPT TOES

Facility

$16,057.73

Service Code	APR-DRG 3051
Hospital Charge Code	APRDRG 3051
Min. Negotiated Rate	$3,817.27
Max. Negotiated Rate	$16,057.73
Rate for Payer: Buckeye Health Medicaid OOS	$3,817.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,057.73
Rate for Payer: Managed Health Services Medicaid	$16,057.73
Rate for Payer: MDWise Medicaid	$16,057.73
Rate for Payer: Molina Healthcare of OH Medicare	$3,817.27

INPATIENT APRDRG 3052: AMPUTATION OF LOWER LIMB EXCEPT TOES

Facility

$20,017.90

Service Code	APR-DRG 3052
Hospital Charge Code	APRDRG 3052
Min. Negotiated Rate	$4,616.85
Max. Negotiated Rate	$20,017.90
Rate for Payer: Buckeye Health Medicaid OOS	$4,616.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,017.90
Rate for Payer: Managed Health Services Medicaid	$20,017.90
Rate for Payer: MDWise Medicaid	$20,017.90
Rate for Payer: Molina Healthcare of OH Medicare	$4,616.85

INPATIENT APRDRG 3053: AMPUTATION OF LOWER LIMB EXCEPT TOES

Facility

$31,622.13

Service Code	APR-DRG 3053
Hospital Charge Code	APRDRG 3053
Min. Negotiated Rate	$6,813.83
Max. Negotiated Rate	$31,622.13
Rate for Payer: Buckeye Health Medicaid OOS	$6,813.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$31,622.13
Rate for Payer: Managed Health Services Medicaid	$31,622.13
Rate for Payer: MDWise Medicaid	$31,622.13
Rate for Payer: Molina Healthcare of OH Medicare	$6,813.83

INPATIENT APRDRG 3054: AMPUTATION OF LOWER LIMB EXCEPT TOES

Facility

$39,922.33

Service Code	APR-DRG 3054
Hospital Charge Code	APRDRG 3054
Min. Negotiated Rate	$15,493.55
Max. Negotiated Rate	$39,922.33
Rate for Payer: Buckeye Health Medicaid OOS	$15,493.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$39,922.33
Rate for Payer: Managed Health Services Medicaid	$39,922.33
Rate for Payer: MDWise Medicaid	$39,922.33
Rate for Payer: Molina Healthcare of OH Medicare	$15,493.55

INPATIENT APRDRG 3081: HIP & FEMUR FRACTURE REPAIR

Facility

$15,980.03

Service Code	APR-DRG 3081
Hospital Charge Code	APRDRG 3081
Min. Negotiated Rate	$4,499.65
Max. Negotiated Rate	$15,980.03
Rate for Payer: Buckeye Health Medicaid OOS	$4,499.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,980.03
Rate for Payer: Managed Health Services Medicaid	$15,980.03
Rate for Payer: MDWise Medicaid	$15,980.03
Rate for Payer: Molina Healthcare of OH Medicare	$4,499.65

INPATIENT APRDRG 3082: HIP & FEMUR FRACTURE REPAIR

Facility

$23,902.83

Service Code	APR-DRG 3082
Hospital Charge Code	APRDRG 3082
Min. Negotiated Rate	$5,787.23
Max. Negotiated Rate	$23,902.83
Rate for Payer: Buckeye Health Medicaid OOS	$5,787.23
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,902.83
Rate for Payer: Managed Health Services Medicaid	$23,902.83
Rate for Payer: MDWise Medicaid	$23,902.83
Rate for Payer: Molina Healthcare of OH Medicare	$5,787.23

INPATIENT APRDRG 3083: HIP & FEMUR FRACTURE REPAIR

Facility

$30,080.49

Service Code	APR-DRG 3083
Hospital Charge Code	APRDRG 3083
Min. Negotiated Rate	$7,805.86
Max. Negotiated Rate	$30,080.49
Rate for Payer: Buckeye Health Medicaid OOS	$7,805.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$30,080.49
Rate for Payer: Managed Health Services Medicaid	$30,080.49
Rate for Payer: MDWise Medicaid	$30,080.49
Rate for Payer: Molina Healthcare of OH Medicare	$7,805.86

INPATIENT APRDRG 3084: HIP & FEMUR FRACTURE REPAIR

Facility

$34,741.18

Service Code	APR-DRG 3084
Hospital Charge Code	APRDRG 3084
Min. Negotiated Rate	$12,970.59
Max. Negotiated Rate	$34,741.18
Rate for Payer: Buckeye Health Medicaid OOS	$12,970.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,741.18
Rate for Payer: Managed Health Services Medicaid	$34,741.18
Rate for Payer: MDWise Medicaid	$34,741.18
Rate for Payer: Molina Healthcare of OH Medicare	$12,970.59

INPATIENT APRDRG 3091: OTHER SIGNIFICANT HIP & FEMUR SURGERY

Facility

$17,575.94

Service Code	APR-DRG 3091
Hospital Charge Code	APRDRG 3091
Min. Negotiated Rate	$5,095.25
Max. Negotiated Rate	$17,575.94
Rate for Payer: Buckeye Health Medicaid OOS	$5,095.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,575.94
Rate for Payer: Managed Health Services Medicaid	$17,575.94
Rate for Payer: MDWise Medicaid	$17,575.94
Rate for Payer: Molina Healthcare of OH Medicare	$5,095.25

INPATIENT APRDRG 3092: OTHER SIGNIFICANT HIP & FEMUR SURGERY

Facility

$25,703.47

Service Code	APR-DRG 3092
Hospital Charge Code	APRDRG 3092
Min. Negotiated Rate	$6,353.05
Max. Negotiated Rate	$25,703.47
Rate for Payer: Buckeye Health Medicaid OOS	$6,353.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,703.47
Rate for Payer: Managed Health Services Medicaid	$25,703.47
Rate for Payer: MDWise Medicaid	$25,703.47
Rate for Payer: Molina Healthcare of OH Medicare	$6,353.05

INPATIENT APRDRG 3093: OTHER SIGNIFICANT HIP & FEMUR SURGERY

Facility

$29,458.90

Service Code	APR-DRG 3093
Hospital Charge Code	APRDRG 3093
Min. Negotiated Rate	$8,662.11
Max. Negotiated Rate	$29,458.90
Rate for Payer: Buckeye Health Medicaid OOS	$8,662.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$29,458.90
Rate for Payer: Managed Health Services Medicaid	$29,458.90
Rate for Payer: MDWise Medicaid	$29,458.90
Rate for Payer: Molina Healthcare of OH Medicare	$8,662.11

INPATIENT APRDRG 3094: OTHER SIGNIFICANT HIP & FEMUR SURGERY

Facility

$46,946.04

Service Code	APR-DRG 3094
Hospital Charge Code	APRDRG 3094
Min. Negotiated Rate	$15,207.28
Max. Negotiated Rate	$46,946.04
Rate for Payer: Buckeye Health Medicaid OOS	$15,207.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$46,946.04
Rate for Payer: Managed Health Services Medicaid	$46,946.04
Rate for Payer: MDWise Medicaid	$46,946.04
Rate for Payer: Molina Healthcare of OH Medicare	$15,207.28

INPATIENT APRDRG 3101: INTERVERTEBRAL DISC EXCISION & DECOMPRESSION

Facility

$10,912.35

Service Code	APR-DRG 3101
Hospital Charge Code	APRDRG 3101
Min. Negotiated Rate	$4,540.63
Max. Negotiated Rate	$10,912.35
Rate for Payer: Buckeye Health Medicaid OOS	$4,540.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,912.35
Rate for Payer: Managed Health Services Medicaid	$10,912.35
Rate for Payer: MDWise Medicaid	$10,912.35
Rate for Payer: Molina Healthcare of OH Medicare	$4,540.63

Know your out-of-pocket cost for care.

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