Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 3843: CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE

Facility IP

$14,470.46

Service Code	APR-DRG 3843
Hospital Charge Code	APRDRG 3843
Min. Negotiated Rate	$3,036.27
Max. Negotiated Rate	$14,470.46
Rate for Payer: Buckeye Health Medicaid OOS	$3,036.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,470.46
Rate for Payer: Managed Health Services Medicaid	$14,470.46
Rate for Payer: MDWise Medicaid	$14,470.46
Rate for Payer: Molina Healthcare of OH Medicare	$3,036.27

INPATIENT APRDRG 3844: CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE

Facility IP

$20,020.36

Service Code	APR-DRG 3844
Hospital Charge Code	APRDRG 3844
Min. Negotiated Rate	$3,036.27
Max. Negotiated Rate	$20,020.36
Rate for Payer: Buckeye Health Medicaid OOS	$3,036.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,020.36
Rate for Payer: Managed Health Services Medicaid	$20,020.36
Rate for Payer: MDWise Medicaid	$20,020.36
Rate for Payer: Molina Healthcare of OH Medicare	$3,036.27

INPATIENT APRDRG 3851: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility IP

$7,799.47

Service Code	APR-DRG 3851
Hospital Charge Code	APRDRG 3851
Min. Negotiated Rate	$1,699.06
Max. Negotiated Rate	$7,799.47
Rate for Payer: Buckeye Health Medicaid OOS	$1,699.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,799.47
Rate for Payer: Managed Health Services Medicaid	$7,799.47
Rate for Payer: MDWise Medicaid	$7,799.47
Rate for Payer: Molina Healthcare of OH Medicare	$1,699.06

INPATIENT APRDRG 3852: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility IP

$10,742.15

Service Code	APR-DRG 3852
Hospital Charge Code	APRDRG 3852
Min. Negotiated Rate	$2,103.81
Max. Negotiated Rate	$10,742.15
Rate for Payer: Buckeye Health Medicaid OOS	$2,103.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,742.15
Rate for Payer: Managed Health Services Medicaid	$10,742.15
Rate for Payer: MDWise Medicaid	$10,742.15
Rate for Payer: Molina Healthcare of OH Medicare	$2,103.81

INPATIENT APRDRG 3853: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility IP

$10,742.15

Service Code	APR-DRG 3853
Hospital Charge Code	APRDRG 3853
Min. Negotiated Rate	$3,512.43
Max. Negotiated Rate	$10,742.15
Rate for Payer: Buckeye Health Medicaid OOS	$3,512.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,742.15
Rate for Payer: Managed Health Services Medicaid	$10,742.15
Rate for Payer: MDWise Medicaid	$10,742.15
Rate for Payer: Molina Healthcare of OH Medicare	$3,512.43

INPATIENT APRDRG 3854: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility IP

$13,835.30

Service Code	APR-DRG 3854
Hospital Charge Code	APRDRG 3854
Min. Negotiated Rate	$3,512.43
Max. Negotiated Rate	$13,835.30
Rate for Payer: Buckeye Health Medicaid OOS	$3,512.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,835.30
Rate for Payer: Managed Health Services Medicaid	$13,835.30
Rate for Payer: MDWise Medicaid	$13,835.30
Rate for Payer: Molina Healthcare of OH Medicare	$3,512.43

INPATIENT APRDRG 4011: ADRENAL PROCEDURES

Facility IP

$17,161.54

Service Code	APR-DRG 4011
Hospital Charge Code	APRDRG 4011
Min. Negotiated Rate	$4,897.03
Max. Negotiated Rate	$17,161.54
Rate for Payer: Buckeye Health Medicaid OOS	$4,897.03
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,161.54
Rate for Payer: Managed Health Services Medicaid	$17,161.54
Rate for Payer: MDWise Medicaid	$17,161.54
Rate for Payer: Molina Healthcare of OH Medicare	$4,897.03

INPATIENT APRDRG 4012: ADRENAL PROCEDURES

Facility IP

$24,013.83

Service Code	APR-DRG 4012
Hospital Charge Code	APRDRG 4012
Min. Negotiated Rate	$4,897.03
Max. Negotiated Rate	$24,013.83
Rate for Payer: Buckeye Health Medicaid OOS	$4,897.03
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,013.83
Rate for Payer: Managed Health Services Medicaid	$24,013.83
Rate for Payer: MDWise Medicaid	$24,013.83
Rate for Payer: Molina Healthcare of OH Medicare	$4,897.03

INPATIENT APRDRG 4013: ADRENAL PROCEDURES

Facility IP

$24,013.83

Service Code	APR-DRG 4013
Hospital Charge Code	APRDRG 4013
Min. Negotiated Rate	$4,897.03
Max. Negotiated Rate	$24,013.83
Rate for Payer: Buckeye Health Medicaid OOS	$4,897.03
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,013.83
Rate for Payer: Managed Health Services Medicaid	$24,013.83
Rate for Payer: MDWise Medicaid	$24,013.83
Rate for Payer: Molina Healthcare of OH Medicare	$4,897.03

INPATIENT APRDRG 4014: ADRENAL PROCEDURES

Facility IP

$24,013.83

Service Code	APR-DRG 4014
Hospital Charge Code	APRDRG 4014
Min. Negotiated Rate	$4,897.03
Max. Negotiated Rate	$24,013.83
Rate for Payer: Buckeye Health Medicaid OOS	$4,897.03
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,013.83
Rate for Payer: Managed Health Services Medicaid	$24,013.83
Rate for Payer: MDWise Medicaid	$24,013.83
Rate for Payer: Molina Healthcare of OH Medicare	$4,897.03

INPATIENT APRDRG 4031: PROCEDURES FOR OBESITY

Facility IP

$20,242.36

Service Code	APR-DRG 4031
Hospital Charge Code	APRDRG 4031
Min. Negotiated Rate	$4,719.95
Max. Negotiated Rate	$20,242.36
Rate for Payer: Buckeye Health Medicaid OOS	$4,719.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,242.36
Rate for Payer: Managed Health Services Medicaid	$20,242.36
Rate for Payer: MDWise Medicaid	$20,242.36
Rate for Payer: Molina Healthcare of OH Medicare	$4,719.95

INPATIENT APRDRG 4032: PROCEDURES FOR OBESITY

Facility IP

$23,107.34

Service Code	APR-DRG 4032
Hospital Charge Code	APRDRG 4032
Min. Negotiated Rate	$4,984.13
Max. Negotiated Rate	$23,107.34
Rate for Payer: Buckeye Health Medicaid OOS	$4,984.13
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,107.34
Rate for Payer: Managed Health Services Medicaid	$23,107.34
Rate for Payer: MDWise Medicaid	$23,107.34
Rate for Payer: Molina Healthcare of OH Medicare	$4,984.13

INPATIENT APRDRG 4033: PROCEDURES FOR OBESITY

Facility IP

$23,346.61

Service Code	APR-DRG 4033
Hospital Charge Code	APRDRG 4033
Min. Negotiated Rate	$7,229.79
Max. Negotiated Rate	$23,346.61
Rate for Payer: Buckeye Health Medicaid OOS	$7,229.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,346.61
Rate for Payer: Managed Health Services Medicaid	$23,346.61
Rate for Payer: MDWise Medicaid	$23,346.61
Rate for Payer: Molina Healthcare of OH Medicare	$7,229.79

INPATIENT APRDRG 4034: PROCEDURES FOR OBESITY

Facility IP

$60,893.57

Service Code	APR-DRG 4034
Hospital Charge Code	APRDRG 4034
Min. Negotiated Rate	$7,229.79
Max. Negotiated Rate	$60,893.57
Rate for Payer: Buckeye Health Medicaid OOS	$7,229.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$60,893.57
Rate for Payer: Managed Health Services Medicaid	$60,893.57
Rate for Payer: MDWise Medicaid	$60,893.57
Rate for Payer: Molina Healthcare of OH Medicare	$7,229.79

INPATIENT APRDRG 4041: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility IP

$11,472.27

Service Code	APR-DRG 4041
Hospital Charge Code	APRDRG 4041
Min. Negotiated Rate	$3,797.10
Max. Negotiated Rate	$11,472.27
Rate for Payer: Buckeye Health Medicaid OOS	$3,797.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,472.27
Rate for Payer: Managed Health Services Medicaid	$11,472.27
Rate for Payer: MDWise Medicaid	$11,472.27
Rate for Payer: Molina Healthcare of OH Medicare	$3,797.10

INPATIENT APRDRG 4042: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility IP

$17,114.68

Service Code	APR-DRG 4042
Hospital Charge Code	APRDRG 4042
Min. Negotiated Rate	$4,499.97
Max. Negotiated Rate	$17,114.68
Rate for Payer: Buckeye Health Medicaid OOS	$4,499.97
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,114.68
Rate for Payer: Managed Health Services Medicaid	$17,114.68
Rate for Payer: MDWise Medicaid	$17,114.68
Rate for Payer: Molina Healthcare of OH Medicare	$4,499.97

INPATIENT APRDRG 4043: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility IP

$25,886.00

Service Code	APR-DRG 4043
Hospital Charge Code	APRDRG 4043
Min. Negotiated Rate	$8,607.67
Max. Negotiated Rate	$25,886.00
Rate for Payer: Buckeye Health Medicaid OOS	$8,607.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,886.00
Rate for Payer: Managed Health Services Medicaid	$25,886.00
Rate for Payer: MDWise Medicaid	$25,886.00
Rate for Payer: Molina Healthcare of OH Medicare	$8,607.67

INPATIENT APRDRG 4044: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility IP

$33,904.99

Service Code	APR-DRG 4044
Hospital Charge Code	APRDRG 4044
Min. Negotiated Rate	$8,607.67
Max. Negotiated Rate	$33,904.99
Rate for Payer: Buckeye Health Medicaid OOS	$8,607.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$33,904.99
Rate for Payer: Managed Health Services Medicaid	$33,904.99
Rate for Payer: MDWise Medicaid	$33,904.99
Rate for Payer: Molina Healthcare of OH Medicare	$8,607.67

INPATIENT APRDRG 4051: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility IP

$15,284.44

Service Code	APR-DRG 4051
Hospital Charge Code	APRDRG 4051
Min. Negotiated Rate	$5,413.86
Max. Negotiated Rate	$15,284.44
Rate for Payer: Buckeye Health Medicaid OOS	$5,413.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,284.44
Rate for Payer: Managed Health Services Medicaid	$15,284.44
Rate for Payer: MDWise Medicaid	$15,284.44
Rate for Payer: Molina Healthcare of OH Medicare	$5,413.86

INPATIENT APRDRG 4052: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility IP

$17,636.37

Service Code	APR-DRG 4052
Hospital Charge Code	APRDRG 4052
Min. Negotiated Rate	$5,413.86
Max. Negotiated Rate	$17,636.37
Rate for Payer: Buckeye Health Medicaid OOS	$5,413.86
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,636.37
Rate for Payer: Managed Health Services Medicaid	$17,636.37
Rate for Payer: MDWise Medicaid	$17,636.37
Rate for Payer: Molina Healthcare of OH Medicare	$5,413.86

INPATIENT APRDRG 4053: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility IP

$26,306.56

Service Code	APR-DRG 4053
Hospital Charge Code	APRDRG 4053
Min. Negotiated Rate	$8,121.59
Max. Negotiated Rate	$26,306.56
Rate for Payer: Buckeye Health Medicaid OOS	$8,121.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$26,306.56
Rate for Payer: Managed Health Services Medicaid	$26,306.56
Rate for Payer: MDWise Medicaid	$26,306.56
Rate for Payer: Molina Healthcare of OH Medicare	$8,121.59

INPATIENT APRDRG 4054: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility IP

$58,415.85

Service Code	APR-DRG 4054
Hospital Charge Code	APRDRG 4054
Min. Negotiated Rate	$14,830.71
Max. Negotiated Rate	$58,415.85
Rate for Payer: Buckeye Health Medicaid OOS	$14,830.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$58,415.85
Rate for Payer: Managed Health Services Medicaid	$58,415.85
Rate for Payer: MDWise Medicaid	$58,415.85
Rate for Payer: Molina Healthcare of OH Medicare	$14,830.71

INPATIENT APRDRG 4201: DIABETES

Facility IP

$7,245.71

Service Code	APR-DRG 4201
Hospital Charge Code	APRDRG 4201
Min. Negotiated Rate	$1,648.46
Max. Negotiated Rate	$7,245.71
Rate for Payer: Buckeye Health Medicaid OOS	$1,648.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,245.71
Rate for Payer: Managed Health Services Medicaid	$7,245.71
Rate for Payer: MDWise Medicaid	$7,245.71
Rate for Payer: Molina Healthcare of OH Medicare	$1,648.46

INPATIENT APRDRG 4202: DIABETES

Facility IP

$8,381.59

Service Code	APR-DRG 4202
Hospital Charge Code	APRDRG 4202
Min. Negotiated Rate	$1,906.87
Max. Negotiated Rate	$8,381.59
Rate for Payer: Buckeye Health Medicaid OOS	$1,906.87
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,381.59
Rate for Payer: Managed Health Services Medicaid	$8,381.59
Rate for Payer: MDWise Medicaid	$8,381.59
Rate for Payer: Molina Healthcare of OH Medicare	$1,906.87

INPATIENT APRDRG 4203: DIABETES

Facility IP

$12,246.79

Service Code	APR-DRG 4203
Hospital Charge Code	APRDRG 4203
Min. Negotiated Rate	$2,634.72
Max. Negotiated Rate	$12,246.79
Rate for Payer: Buckeye Health Medicaid OOS	$2,634.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,246.79
Rate for Payer: Managed Health Services Medicaid	$12,246.79
Rate for Payer: MDWise Medicaid	$12,246.79
Rate for Payer: Molina Healthcare of OH Medicare	$2,634.72

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