Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 3102: INTERVERTEBRAL DISC EXCISION & DECOMPRESSION

Facility

$15,485.47

Service Code	APR-DRG 3102
Hospital Charge Code	APRDRG 3102
Min. Negotiated Rate	$5,702.05
Max. Negotiated Rate	$15,485.47
Rate for Payer: Buckeye Health Medicaid OOS	$5,702.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,485.47
Rate for Payer: Managed Health Services Medicaid	$15,485.47
Rate for Payer: MDWise Medicaid	$15,485.47
Rate for Payer: Molina Healthcare of OH Medicare	$5,702.05

INPATIENT APRDRG 3103: INTERVERTEBRAL DISC EXCISION & DECOMPRESSION

Facility

$21,961.60

Service Code	APR-DRG 3103
Hospital Charge Code	APRDRG 3103
Min. Negotiated Rate	$8,495.92
Max. Negotiated Rate	$21,961.60
Rate for Payer: Buckeye Health Medicaid OOS	$8,495.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,961.60
Rate for Payer: Managed Health Services Medicaid	$21,961.60
Rate for Payer: MDWise Medicaid	$21,961.60
Rate for Payer: Molina Healthcare of OH Medicare	$8,495.92

INPATIENT APRDRG 3104: INTERVERTEBRAL DISC EXCISION & DECOMPRESSION

Facility

$33,464.70

Service Code	APR-DRG 3104
Hospital Charge Code	APRDRG 3104
Min. Negotiated Rate	$8,495.92
Max. Negotiated Rate	$33,464.70
Rate for Payer: Buckeye Health Medicaid OOS	$8,495.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$33,464.70
Rate for Payer: Managed Health Services Medicaid	$33,464.70
Rate for Payer: MDWise Medicaid	$33,464.70
Rate for Payer: Molina Healthcare of OH Medicare	$8,495.92

INPATIENT APRDRG 3121: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES

Facility

$16,583.12

Service Code	APR-DRG 3121
Hospital Charge Code	APRDRG 3121
Min. Negotiated Rate	$4,094.90
Max. Negotiated Rate	$16,583.12
Rate for Payer: Buckeye Health Medicaid OOS	$4,094.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,583.12
Rate for Payer: Managed Health Services Medicaid	$16,583.12
Rate for Payer: MDWise Medicaid	$16,583.12
Rate for Payer: Molina Healthcare of OH Medicare	$4,094.90

INPATIENT APRDRG 3122: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES

Facility

$16,583.12

Service Code	APR-DRG 3122
Hospital Charge Code	APRDRG 3122
Min. Negotiated Rate	$6,564.07
Max. Negotiated Rate	$16,583.12
Rate for Payer: Buckeye Health Medicaid OOS	$6,564.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,583.12
Rate for Payer: Managed Health Services Medicaid	$16,583.12
Rate for Payer: MDWise Medicaid	$16,583.12
Rate for Payer: Molina Healthcare of OH Medicare	$6,564.07

INPATIENT APRDRG 3123: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES

Facility

$31,474.14

Service Code	APR-DRG 3123
Hospital Charge Code	APRDRG 3123
Min. Negotiated Rate	$10,150.46
Max. Negotiated Rate	$31,474.14
Rate for Payer: Buckeye Health Medicaid OOS	$10,150.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$31,474.14
Rate for Payer: Managed Health Services Medicaid	$31,474.14
Rate for Payer: MDWise Medicaid	$31,474.14
Rate for Payer: Molina Healthcare of OH Medicare	$10,150.46

INPATIENT APRDRG 3124: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL & CONNECTIVE TISSUE DIAGNOSES

Facility

$86,462.61

Service Code	APR-DRG 3124
Hospital Charge Code	APRDRG 3124
Min. Negotiated Rate	$21,950.99
Max. Negotiated Rate	$86,462.61
Rate for Payer: Buckeye Health Medicaid OOS	$21,950.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$86,462.61
Rate for Payer: Managed Health Services Medicaid	$86,462.61
Rate for Payer: MDWise Medicaid	$86,462.61
Rate for Payer: Molina Healthcare of OH Medicare	$21,950.99

INPATIENT APRDRG 3131: KNEE & LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$18,714.28

Service Code	APR-DRG 3131
Hospital Charge Code	APRDRG 3131
Min. Negotiated Rate	$4,333.14
Max. Negotiated Rate	$18,714.28
Rate for Payer: Buckeye Health Medicaid OOS	$4,333.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,714.28
Rate for Payer: Managed Health Services Medicaid	$18,714.28
Rate for Payer: MDWise Medicaid	$18,714.28
Rate for Payer: Molina Healthcare of OH Medicare	$4,333.14

INPATIENT APRDRG 3132: KNEE & LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$25,025.14

Service Code	APR-DRG 3132
Hospital Charge Code	APRDRG 3132
Min. Negotiated Rate	$5,428.27
Max. Negotiated Rate	$25,025.14
Rate for Payer: Buckeye Health Medicaid OOS	$5,428.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,025.14
Rate for Payer: Managed Health Services Medicaid	$25,025.14
Rate for Payer: MDWise Medicaid	$25,025.14
Rate for Payer: Molina Healthcare of OH Medicare	$5,428.27

INPATIENT APRDRG 3133: KNEE & LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$36,333.39

Service Code	APR-DRG 3133
Hospital Charge Code	APRDRG 3133
Min. Negotiated Rate	$7,790.81
Max. Negotiated Rate	$36,333.39
Rate for Payer: Buckeye Health Medicaid OOS	$7,790.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$36,333.39
Rate for Payer: Managed Health Services Medicaid	$36,333.39
Rate for Payer: MDWise Medicaid	$36,333.39
Rate for Payer: Molina Healthcare of OH Medicare	$7,790.81

INPATIENT APRDRG 3134: KNEE & LOWER LEG PROCEDURES EXCEPT FOOT

Facility

$46,576.05

Service Code	APR-DRG 3134
Hospital Charge Code	APRDRG 3134
Min. Negotiated Rate	$12,902.38
Max. Negotiated Rate	$46,576.05
Rate for Payer: Buckeye Health Medicaid OOS	$12,902.38
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$46,576.05
Rate for Payer: Managed Health Services Medicaid	$46,576.05
Rate for Payer: MDWise Medicaid	$46,576.05
Rate for Payer: Molina Healthcare of OH Medicare	$12,902.38

INPATIENT APRDRG 3141: FOOT & TOE PROCEDURES

Facility

$13,732.93

Service Code	APR-DRG 3141
Hospital Charge Code	APRDRG 3141
Min. Negotiated Rate	$3,976.42
Max. Negotiated Rate	$13,732.93
Rate for Payer: Buckeye Health Medicaid OOS	$3,976.42
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,732.93
Rate for Payer: Managed Health Services Medicaid	$13,732.93
Rate for Payer: MDWise Medicaid	$13,732.93
Rate for Payer: Molina Healthcare of OH Medicare	$3,976.42

INPATIENT APRDRG 3142: FOOT & TOE PROCEDURES

Facility

$18,356.62

Service Code	APR-DRG 3142
Hospital Charge Code	APRDRG 3142
Min. Negotiated Rate	$4,093.94
Max. Negotiated Rate	$18,356.62
Rate for Payer: Buckeye Health Medicaid OOS	$4,093.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,356.62
Rate for Payer: Managed Health Services Medicaid	$18,356.62
Rate for Payer: MDWise Medicaid	$18,356.62
Rate for Payer: Molina Healthcare of OH Medicare	$4,093.94

INPATIENT APRDRG 3143: FOOT & TOE PROCEDURES

Facility

$22,459.85

Service Code	APR-DRG 3143
Hospital Charge Code	APRDRG 3143
Min. Negotiated Rate	$4,946.67
Max. Negotiated Rate	$22,459.85
Rate for Payer: Buckeye Health Medicaid OOS	$4,946.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,459.85
Rate for Payer: Managed Health Services Medicaid	$22,459.85
Rate for Payer: MDWise Medicaid	$22,459.85
Rate for Payer: Molina Healthcare of OH Medicare	$4,946.67

INPATIENT APRDRG 3144: FOOT & TOE PROCEDURES

Facility

$31,687.50

Service Code	APR-DRG 3144
Hospital Charge Code	APRDRG 3144
Min. Negotiated Rate	$8,205.16
Max. Negotiated Rate	$31,687.50
Rate for Payer: Buckeye Health Medicaid OOS	$8,205.16
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$31,687.50
Rate for Payer: Managed Health Services Medicaid	$31,687.50
Rate for Payer: MDWise Medicaid	$31,687.50
Rate for Payer: Molina Healthcare of OH Medicare	$8,205.16

INPATIENT APRDRG 3151: SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$16,528.85

Service Code	APR-DRG 3151
Hospital Charge Code	APRDRG 3151
Min. Negotiated Rate	$2,884.81
Max. Negotiated Rate	$16,528.85
Rate for Payer: Buckeye Health Medicaid OOS	$2,884.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,528.85
Rate for Payer: Managed Health Services Medicaid	$16,528.85
Rate for Payer: MDWise Medicaid	$16,528.85
Rate for Payer: Molina Healthcare of OH Medicare	$2,884.81

INPATIENT APRDRG 3152: SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$17,931.13

Service Code	APR-DRG 3152
Hospital Charge Code	APRDRG 3152
Min. Negotiated Rate	$5,309.79
Max. Negotiated Rate	$17,931.13
Rate for Payer: Buckeye Health Medicaid OOS	$5,309.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,931.13
Rate for Payer: Managed Health Services Medicaid	$17,931.13
Rate for Payer: MDWise Medicaid	$17,931.13
Rate for Payer: Molina Healthcare of OH Medicare	$5,309.79

INPATIENT APRDRG 3153: SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$32,707.45

Service Code	APR-DRG 3153
Hospital Charge Code	APRDRG 3153
Min. Negotiated Rate	$7,070.00
Max. Negotiated Rate	$32,707.45
Rate for Payer: Buckeye Health Medicaid OOS	$7,070.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$32,707.45
Rate for Payer: Managed Health Services Medicaid	$32,707.45
Rate for Payer: MDWise Medicaid	$32,707.45
Rate for Payer: Molina Healthcare of OH Medicare	$7,070.00

INPATIENT APRDRG 3154: SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$38,648.31

Service Code	APR-DRG 3154
Hospital Charge Code	APRDRG 3154
Min. Negotiated Rate	$12,501.15
Max. Negotiated Rate	$38,648.31
Rate for Payer: Buckeye Health Medicaid OOS	$12,501.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$38,648.31
Rate for Payer: Managed Health Services Medicaid	$38,648.31
Rate for Payer: MDWise Medicaid	$38,648.31
Rate for Payer: Molina Healthcare of OH Medicare	$12,501.15

INPATIENT APRDRG 3161: HAND & WRIST PROCEDURES

Facility

$10,321.59

Service Code	APR-DRG 3161
Hospital Charge Code	APRDRG 3161
Min. Negotiated Rate	$2,680.83
Max. Negotiated Rate	$10,321.59
Rate for Payer: Buckeye Health Medicaid OOS	$2,680.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,321.59
Rate for Payer: Managed Health Services Medicaid	$10,321.59
Rate for Payer: MDWise Medicaid	$10,321.59
Rate for Payer: Molina Healthcare of OH Medicare	$2,680.83

INPATIENT APRDRG 3162: HAND & WRIST PROCEDURES

Facility

$14,617.22

Service Code	APR-DRG 3162
Hospital Charge Code	APRDRG 3162
Min. Negotiated Rate	$3,785.57
Max. Negotiated Rate	$14,617.22
Rate for Payer: Buckeye Health Medicaid OOS	$3,785.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,617.22
Rate for Payer: Managed Health Services Medicaid	$14,617.22
Rate for Payer: MDWise Medicaid	$14,617.22
Rate for Payer: Molina Healthcare of OH Medicare	$3,785.57

INPATIENT APRDRG 3163: HAND & WRIST PROCEDURES

Facility

$19,396.31

Service Code	APR-DRG 3163
Hospital Charge Code	APRDRG 3163
Min. Negotiated Rate	$5,155.13
Max. Negotiated Rate	$19,396.31
Rate for Payer: Buckeye Health Medicaid OOS	$5,155.13
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,396.31
Rate for Payer: Managed Health Services Medicaid	$19,396.31
Rate for Payer: MDWise Medicaid	$19,396.31
Rate for Payer: Molina Healthcare of OH Medicare	$5,155.13

INPATIENT APRDRG 3164: HAND & WRIST PROCEDURES

Facility

$32,603.85

Service Code	APR-DRG 3164
Hospital Charge Code	APRDRG 3164
Min. Negotiated Rate	$5,155.13
Max. Negotiated Rate	$32,603.85
Rate for Payer: Buckeye Health Medicaid OOS	$5,155.13
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$32,603.85
Rate for Payer: Managed Health Services Medicaid	$32,603.85
Rate for Payer: MDWise Medicaid	$32,603.85
Rate for Payer: Molina Healthcare of OH Medicare	$5,155.13

INPATIENT APRDRG 3171: TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES

Facility

$11,586.97

Service Code	APR-DRG 3171
Hospital Charge Code	APRDRG 3171
Min. Negotiated Rate	$3,162.11
Max. Negotiated Rate	$11,586.97
Rate for Payer: Buckeye Health Medicaid OOS	$3,162.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,586.97
Rate for Payer: Managed Health Services Medicaid	$11,586.97
Rate for Payer: MDWise Medicaid	$11,586.97
Rate for Payer: Molina Healthcare of OH Medicare	$3,162.11

INPATIENT APRDRG 3172: TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES

Facility

$19,249.54

Service Code	APR-DRG 3172
Hospital Charge Code	APRDRG 3172
Min. Negotiated Rate	$4,196.08
Max. Negotiated Rate	$19,249.54
Rate for Payer: Buckeye Health Medicaid OOS	$4,196.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,249.54
Rate for Payer: Managed Health Services Medicaid	$19,249.54
Rate for Payer: MDWise Medicaid	$19,249.54
Rate for Payer: Molina Healthcare of OH Medicare	$4,196.08

Know your out-of-pocket cost for care.

All Charges