Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 3461: CONNECTIVE TISSUE DISORDERS

Facility

$9,436.07

Service Code	APR-DRG 3461
Hospital Charge Code	APRDRG 3461
Min. Negotiated Rate	$3,078.86
Max. Negotiated Rate	$9,436.07
Rate for Payer: Buckeye Health Medicaid OOS	$3,078.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,436.07
Rate for Payer: Managed Health Services Medicaid	$9,436.07
Rate for Payer: MDWise Medicaid	$9,436.07
Rate for Payer: Molina Healthcare of OH Medicare	$3,078.86

INPATIENT APRDRG 3462: CONNECTIVE TISSUE DISORDERS

Facility

$13,222.34

Service Code	APR-DRG 3462
Hospital Charge Code	APRDRG 3462
Min. Negotiated Rate	$3,761.23
Max. Negotiated Rate	$13,222.34
Rate for Payer: Buckeye Health Medicaid OOS	$3,761.23
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,222.34
Rate for Payer: Managed Health Services Medicaid	$13,222.34
Rate for Payer: MDWise Medicaid	$13,222.34
Rate for Payer: Molina Healthcare of OH Medicare	$3,761.23

INPATIENT APRDRG 3463: CONNECTIVE TISSUE DISORDERS

Facility

$15,563.17

Service Code	APR-DRG 3463
Hospital Charge Code	APRDRG 3463
Min. Negotiated Rate	$5,192.27
Max. Negotiated Rate	$15,563.17
Rate for Payer: Buckeye Health Medicaid OOS	$5,192.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,563.17
Rate for Payer: Managed Health Services Medicaid	$15,563.17
Rate for Payer: MDWise Medicaid	$15,563.17
Rate for Payer: Molina Healthcare of OH Medicare	$5,192.27

INPATIENT APRDRG 3464: CONNECTIVE TISSUE DISORDERS

Facility

$33,935.83

Service Code	APR-DRG 3464
Hospital Charge Code	APRDRG 3464
Min. Negotiated Rate	$10,622.14
Max. Negotiated Rate	$33,935.83
Rate for Payer: Buckeye Health Medicaid OOS	$10,622.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$33,935.83
Rate for Payer: Managed Health Services Medicaid	$33,935.83
Rate for Payer: MDWise Medicaid	$33,935.83
Rate for Payer: Molina Healthcare of OH Medicare	$10,622.14

INPATIENT APRDRG 3471: OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES

Facility

$19,102.78

Service Code	APR-DRG 3471
Hospital Charge Code	APRDRG 3471
Min. Negotiated Rate	$2,349.09
Max. Negotiated Rate	$19,102.78
Rate for Payer: Buckeye Health Medicaid OOS	$2,349.09
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,102.78
Rate for Payer: Managed Health Services Medicaid	$19,102.78
Rate for Payer: MDWise Medicaid	$19,102.78
Rate for Payer: Molina Healthcare of OH Medicare	$2,349.09

INPATIENT APRDRG 3472: OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES

Facility

$22,251.42

Service Code	APR-DRG 3472
Hospital Charge Code	APRDRG 3472
Min. Negotiated Rate	$2,522.33
Max. Negotiated Rate	$22,251.42
Rate for Payer: Buckeye Health Medicaid OOS	$2,522.33
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,251.42
Rate for Payer: Managed Health Services Medicaid	$22,251.42
Rate for Payer: MDWise Medicaid	$22,251.42
Rate for Payer: Molina Healthcare of OH Medicare	$2,522.33

INPATIENT APRDRG 3473: OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES

Facility

$22,251.42

Service Code	APR-DRG 3473
Hospital Charge Code	APRDRG 3473
Min. Negotiated Rate	$3,202.78
Max. Negotiated Rate	$22,251.42
Rate for Payer: Buckeye Health Medicaid OOS	$3,202.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,251.42
Rate for Payer: Managed Health Services Medicaid	$22,251.42
Rate for Payer: MDWise Medicaid	$22,251.42
Rate for Payer: Molina Healthcare of OH Medicare	$3,202.78

INPATIENT APRDRG 3474: OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES

Facility

$22,251.42

Service Code	APR-DRG 3474
Hospital Charge Code	APRDRG 3474
Min. Negotiated Rate	$5,811.88
Max. Negotiated Rate	$22,251.42
Rate for Payer: Buckeye Health Medicaid OOS	$5,811.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,251.42
Rate for Payer: Managed Health Services Medicaid	$22,251.42
Rate for Payer: MDWise Medicaid	$22,251.42
Rate for Payer: Molina Healthcare of OH Medicare	$5,811.88

INPATIENT APRDRG 3491: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$5,584.44

Service Code	APR-DRG 3491
Hospital Charge Code	APRDRG 3491
Min. Negotiated Rate	$2,554.35
Max. Negotiated Rate	$5,584.44
Rate for Payer: Buckeye Health Medicaid OOS	$2,554.35
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$5,584.44
Rate for Payer: Managed Health Services Medicaid	$5,584.44
Rate for Payer: MDWise Medicaid	$5,584.44
Rate for Payer: Molina Healthcare of OH Medicare	$2,554.35

INPATIENT APRDRG 3492: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$18,835.15

Service Code	APR-DRG 3492
Hospital Charge Code	APRDRG 3492
Min. Negotiated Rate	$2,637.92
Max. Negotiated Rate	$18,835.15
Rate for Payer: Buckeye Health Medicaid OOS	$2,637.92
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,835.15
Rate for Payer: Managed Health Services Medicaid	$18,835.15
Rate for Payer: MDWise Medicaid	$18,835.15
Rate for Payer: Molina Healthcare of OH Medicare	$2,637.92

INPATIENT APRDRG 3493: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$23,445.27

Service Code	APR-DRG 3493
Hospital Charge Code	APRDRG 3493
Min. Negotiated Rate	$3,588.64
Max. Negotiated Rate	$23,445.27
Rate for Payer: Buckeye Health Medicaid OOS	$3,588.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,445.27
Rate for Payer: Managed Health Services Medicaid	$23,445.27
Rate for Payer: MDWise Medicaid	$23,445.27
Rate for Payer: Molina Healthcare of OH Medicare	$3,588.64

INPATIENT APRDRG 3494: MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE

Facility

$23,445.27

Service Code	APR-DRG 3494
Hospital Charge Code	APRDRG 3494
Min. Negotiated Rate	$4,973.56
Max. Negotiated Rate	$23,445.27
Rate for Payer: Buckeye Health Medicaid OOS	$4,973.56
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,445.27
Rate for Payer: Managed Health Services Medicaid	$23,445.27
Rate for Payer: MDWise Medicaid	$23,445.27
Rate for Payer: Molina Healthcare of OH Medicare	$4,973.56

INPATIENT APRDRG 3511: OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$20,329.92

Service Code	APR-DRG 3511
Hospital Charge Code	APRDRG 3511
Min. Negotiated Rate	$2,154.40
Max. Negotiated Rate	$20,329.92
Rate for Payer: Buckeye Health Medicaid OOS	$2,154.40
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,329.92
Rate for Payer: Managed Health Services Medicaid	$20,329.92
Rate for Payer: MDWise Medicaid	$20,329.92
Rate for Payer: Molina Healthcare of OH Medicare	$2,154.40

INPATIENT APRDRG 3512: OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$20,329.92

Service Code	APR-DRG 3512
Hospital Charge Code	APRDRG 3512
Min. Negotiated Rate	$2,267.12
Max. Negotiated Rate	$20,329.92
Rate for Payer: Buckeye Health Medicaid OOS	$2,267.12
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,329.92
Rate for Payer: Managed Health Services Medicaid	$20,329.92
Rate for Payer: MDWise Medicaid	$20,329.92
Rate for Payer: Molina Healthcare of OH Medicare	$2,267.12

INPATIENT APRDRG 3513: OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$20,329.92

Service Code	APR-DRG 3513
Hospital Charge Code	APRDRG 3513
Min. Negotiated Rate	$4,376.68
Max. Negotiated Rate	$20,329.92
Rate for Payer: Buckeye Health Medicaid OOS	$4,376.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,329.92
Rate for Payer: Managed Health Services Medicaid	$20,329.92
Rate for Payer: MDWise Medicaid	$20,329.92
Rate for Payer: Molina Healthcare of OH Medicare	$4,376.68

INPATIENT APRDRG 3514: OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES

Facility

$20,329.92

Service Code	APR-DRG 3514
Hospital Charge Code	APRDRG 3514
Min. Negotiated Rate	$4,376.68
Max. Negotiated Rate	$20,329.92
Rate for Payer: Buckeye Health Medicaid OOS	$4,376.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,329.92
Rate for Payer: Managed Health Services Medicaid	$20,329.92
Rate for Payer: MDWise Medicaid	$20,329.92
Rate for Payer: Molina Healthcare of OH Medicare	$4,376.68

INPATIENT APRDRG 3611: SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$14,576.52

Service Code	APR-DRG 3611
Hospital Charge Code	APRDRG 3611
Min. Negotiated Rate	$3,657.48
Max. Negotiated Rate	$14,576.52
Rate for Payer: Buckeye Health Medicaid OOS	$3,657.48
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,576.52
Rate for Payer: Managed Health Services Medicaid	$14,576.52
Rate for Payer: MDWise Medicaid	$14,576.52
Rate for Payer: Molina Healthcare of OH Medicare	$3,657.48

INPATIENT APRDRG 3612: SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$20,156.03

Service Code	APR-DRG 3612
Hospital Charge Code	APRDRG 3612
Min. Negotiated Rate	$4,305.60
Max. Negotiated Rate	$20,156.03
Rate for Payer: Buckeye Health Medicaid OOS	$4,305.60
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,156.03
Rate for Payer: Managed Health Services Medicaid	$20,156.03
Rate for Payer: MDWise Medicaid	$20,156.03
Rate for Payer: Molina Healthcare of OH Medicare	$4,305.60

INPATIENT APRDRG 3613: SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$25,310.04

Service Code	APR-DRG 3613
Hospital Charge Code	APRDRG 3613
Min. Negotiated Rate	$8,079.32
Max. Negotiated Rate	$25,310.04
Rate for Payer: Buckeye Health Medicaid OOS	$8,079.32
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,310.04
Rate for Payer: Managed Health Services Medicaid	$25,310.04
Rate for Payer: MDWise Medicaid	$25,310.04
Rate for Payer: Molina Healthcare of OH Medicare	$8,079.32

INPATIENT APRDRG 3614: SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$37,634.53

Service Code	APR-DRG 3614
Hospital Charge Code	APRDRG 3614
Min. Negotiated Rate	$8,079.32
Max. Negotiated Rate	$37,634.53
Rate for Payer: Buckeye Health Medicaid OOS	$8,079.32
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$37,634.53
Rate for Payer: Managed Health Services Medicaid	$37,634.53
Rate for Payer: MDWise Medicaid	$37,634.53
Rate for Payer: Molina Healthcare of OH Medicare	$8,079.32

INPATIENT APRDRG 3621: MASTECTOMY PROCEDURES

Facility

$15,825.87

Service Code	APR-DRG 3621
Hospital Charge Code	APRDRG 3621
Min. Negotiated Rate	$3,705.84
Max. Negotiated Rate	$15,825.87
Rate for Payer: Buckeye Health Medicaid OOS	$3,705.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,825.87
Rate for Payer: Managed Health Services Medicaid	$15,825.87
Rate for Payer: MDWise Medicaid	$15,825.87
Rate for Payer: Molina Healthcare of OH Medicare	$3,705.84

INPATIENT APRDRG 3622: MASTECTOMY PROCEDURES

Facility

$22,414.22

Service Code	APR-DRG 3622
Hospital Charge Code	APRDRG 3622
Min. Negotiated Rate	$6,198.06
Max. Negotiated Rate	$22,414.22
Rate for Payer: Buckeye Health Medicaid OOS	$6,198.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,414.22
Rate for Payer: Managed Health Services Medicaid	$22,414.22
Rate for Payer: MDWise Medicaid	$22,414.22
Rate for Payer: Molina Healthcare of OH Medicare	$6,198.06

INPATIENT APRDRG 3623: MASTECTOMY PROCEDURES

Facility

$24,994.31

Service Code	APR-DRG 3623
Hospital Charge Code	APRDRG 3623
Min. Negotiated Rate	$6,198.06
Max. Negotiated Rate	$24,994.31
Rate for Payer: Buckeye Health Medicaid OOS	$6,198.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,994.31
Rate for Payer: Managed Health Services Medicaid	$24,994.31
Rate for Payer: MDWise Medicaid	$24,994.31
Rate for Payer: Molina Healthcare of OH Medicare	$6,198.06

INPATIENT APRDRG 3624: MASTECTOMY PROCEDURES

Facility

$24,994.31

Service Code	APR-DRG 3624
Hospital Charge Code	APRDRG 3624
Min. Negotiated Rate	$6,198.06
Max. Negotiated Rate	$24,994.31
Rate for Payer: Buckeye Health Medicaid OOS	$6,198.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,994.31
Rate for Payer: Managed Health Services Medicaid	$24,994.31
Rate for Payer: MDWise Medicaid	$24,994.31
Rate for Payer: Molina Healthcare of OH Medicare	$6,198.06

INPATIENT APRDRG 3631: BREAST PROCEDURES EXCEPT MASTECTOMY

Facility

$15,230.18

Service Code	APR-DRG 3631
Hospital Charge Code	APRDRG 3631
Min. Negotiated Rate	$2,489.66
Max. Negotiated Rate	$15,230.18
Rate for Payer: Buckeye Health Medicaid OOS	$2,489.66
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,230.18
Rate for Payer: Managed Health Services Medicaid	$15,230.18
Rate for Payer: MDWise Medicaid	$15,230.18
Rate for Payer: Molina Healthcare of OH Medicare	$2,489.66

Know your out-of-pocket cost for care.

All Charges