Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 4653: URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$10,670.62

Service Code	APR-DRG 4653
Hospital Charge Code	APRDRG 4653
Min. Negotiated Rate	$3,182.61
Max. Negotiated Rate	$10,670.62
Rate for Payer: Buckeye Health Medicaid OOS	$3,182.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,670.62
Rate for Payer: Managed Health Services Medicaid	$10,670.62
Rate for Payer: MDWise Medicaid	$10,670.62
Rate for Payer: Molina Healthcare of OH Medicare	$3,182.61

INPATIENT APRDRG 4654: URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$18,087.76

Service Code	APR-DRG 4654
Hospital Charge Code	APRDRG 4654
Min. Negotiated Rate	$3,182.61
Max. Negotiated Rate	$18,087.76
Rate for Payer: Buckeye Health Medicaid OOS	$3,182.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,087.76
Rate for Payer: Managed Health Services Medicaid	$18,087.76
Rate for Payer: MDWise Medicaid	$18,087.76
Rate for Payer: Molina Healthcare of OH Medicare	$3,182.61

INPATIENT APRDRG 4661: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$5,546.21

Service Code	APR-DRG 4661
Hospital Charge Code	APRDRG 4661
Min. Negotiated Rate	$1,962.59
Max. Negotiated Rate	$5,546.21
Rate for Payer: Buckeye Health Medicaid OOS	$1,962.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$5,546.21
Rate for Payer: Managed Health Services Medicaid	$5,546.21
Rate for Payer: MDWise Medicaid	$5,546.21
Rate for Payer: Molina Healthcare of OH Medicare	$1,962.59

INPATIENT APRDRG 4662: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$10,499.19

Service Code	APR-DRG 4662
Hospital Charge Code	APRDRG 4662
Min. Negotiated Rate	$1,962.59
Max. Negotiated Rate	$10,499.19
Rate for Payer: Buckeye Health Medicaid OOS	$1,962.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,499.19
Rate for Payer: Managed Health Services Medicaid	$10,499.19
Rate for Payer: MDWise Medicaid	$10,499.19
Rate for Payer: Molina Healthcare of OH Medicare	$1,962.59

INPATIENT APRDRG 4663: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$14,654.22

Service Code	APR-DRG 4663
Hospital Charge Code	APRDRG 4663
Min. Negotiated Rate	$3,238.00
Max. Negotiated Rate	$14,654.22
Rate for Payer: Buckeye Health Medicaid OOS	$3,238.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,654.22
Rate for Payer: Managed Health Services Medicaid	$14,654.22
Rate for Payer: MDWise Medicaid	$14,654.22
Rate for Payer: Molina Healthcare of OH Medicare	$3,238.00

INPATIENT APRDRG 4664: MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC

Facility

$24,402.32

Service Code	APR-DRG 4664
Hospital Charge Code	APRDRG 4664
Min. Negotiated Rate	$5,575.57
Max. Negotiated Rate	$24,402.32
Rate for Payer: Buckeye Health Medicaid OOS	$5,575.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,402.32
Rate for Payer: Managed Health Services Medicaid	$24,402.32
Rate for Payer: MDWise Medicaid	$24,402.32
Rate for Payer: Molina Healthcare of OH Medicare	$5,575.57

INPATIENT APRDRG 4681: OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$8,887.25

Service Code	APR-DRG 4681
Hospital Charge Code	APRDRG 4681
Min. Negotiated Rate	$1,958.11
Max. Negotiated Rate	$8,887.25
Rate for Payer: Buckeye Health Medicaid OOS	$1,958.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,887.25
Rate for Payer: Managed Health Services Medicaid	$8,887.25
Rate for Payer: MDWise Medicaid	$8,887.25
Rate for Payer: Molina Healthcare of OH Medicare	$1,958.11

INPATIENT APRDRG 4682: OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$14,009.20

Service Code	APR-DRG 4682
Hospital Charge Code	APRDRG 4682
Min. Negotiated Rate	$2,184.82
Max. Negotiated Rate	$14,009.20
Rate for Payer: Buckeye Health Medicaid OOS	$2,184.82
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,009.20
Rate for Payer: Managed Health Services Medicaid	$14,009.20
Rate for Payer: MDWise Medicaid	$14,009.20
Rate for Payer: Molina Healthcare of OH Medicare	$2,184.82

INPATIENT APRDRG 4683: OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$15,970.16

Service Code	APR-DRG 4683
Hospital Charge Code	APRDRG 4683
Min. Negotiated Rate	$3,853.46
Max. Negotiated Rate	$15,970.16
Rate for Payer: Buckeye Health Medicaid OOS	$3,853.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,970.16
Rate for Payer: Managed Health Services Medicaid	$15,970.16
Rate for Payer: MDWise Medicaid	$15,970.16
Rate for Payer: Molina Healthcare of OH Medicare	$3,853.46

INPATIENT APRDRG 4684: OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$19,141.01

Service Code	APR-DRG 4684
Hospital Charge Code	APRDRG 4684
Min. Negotiated Rate	$3,853.46
Max. Negotiated Rate	$19,141.01
Rate for Payer: Buckeye Health Medicaid OOS	$3,853.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,141.01
Rate for Payer: Managed Health Services Medicaid	$19,141.01
Rate for Payer: MDWise Medicaid	$19,141.01
Rate for Payer: Molina Healthcare of OH Medicare	$3,853.46

INPATIENT APRDRG 4691: ACUTE KIDNEY INJURY

Facility

$7,077.98

Service Code	APR-DRG 4691
Hospital Charge Code	APRDRG 4691
Min. Negotiated Rate	$1,352.58
Max. Negotiated Rate	$7,077.98
Rate for Payer: Buckeye Health Medicaid OOS	$1,352.58
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,077.98
Rate for Payer: Managed Health Services Medicaid	$7,077.98
Rate for Payer: MDWise Medicaid	$7,077.98
Rate for Payer: Molina Healthcare of OH Medicare	$1,352.58

INPATIENT APRDRG 4692: ACUTE KIDNEY INJURY

Facility

$9,470.61

Service Code	APR-DRG 4692
Hospital Charge Code	APRDRG 4692
Min. Negotiated Rate	$1,965.15
Max. Negotiated Rate	$9,470.61
Rate for Payer: Buckeye Health Medicaid OOS	$1,965.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,470.61
Rate for Payer: Managed Health Services Medicaid	$9,470.61
Rate for Payer: MDWise Medicaid	$9,470.61
Rate for Payer: Molina Healthcare of OH Medicare	$1,965.15

INPATIENT APRDRG 4693: ACUTE KIDNEY INJURY

Facility

$14,511.15

Service Code	APR-DRG 4693
Hospital Charge Code	APRDRG 4693
Min. Negotiated Rate	$3,050.04
Max. Negotiated Rate	$14,511.15
Rate for Payer: Buckeye Health Medicaid OOS	$3,050.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,511.15
Rate for Payer: Managed Health Services Medicaid	$14,511.15
Rate for Payer: MDWise Medicaid	$14,511.15
Rate for Payer: Molina Healthcare of OH Medicare	$3,050.04

INPATIENT APRDRG 4694: ACUTE KIDNEY INJURY

Facility

$32,656.88

Service Code	APR-DRG 4694
Hospital Charge Code	APRDRG 4694
Min. Negotiated Rate	$6,593.85
Max. Negotiated Rate	$32,656.88
Rate for Payer: Buckeye Health Medicaid OOS	$6,593.85
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$32,656.88
Rate for Payer: Managed Health Services Medicaid	$32,656.88
Rate for Payer: MDWise Medicaid	$32,656.88
Rate for Payer: Molina Healthcare of OH Medicare	$6,593.85

INPATIENT APRDRG 4701: CHRONIC KIDNEY DISEASE

Facility

$4,222.86

Service Code	APR-DRG 4701
Hospital Charge Code	APRDRG 4701
Min. Negotiated Rate	$2,143.51
Max. Negotiated Rate	$4,222.86
Rate for Payer: Buckeye Health Medicaid OOS	$2,143.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$4,222.86
Rate for Payer: Managed Health Services Medicaid	$4,222.86
Rate for Payer: MDWise Medicaid	$4,222.86
Rate for Payer: Molina Healthcare of OH Medicare	$2,143.51

INPATIENT APRDRG 4702: CHRONIC KIDNEY DISEASE

Facility

$9,945.43

Service Code	APR-DRG 4702
Hospital Charge Code	APRDRG 4702
Min. Negotiated Rate	$2,143.51
Max. Negotiated Rate	$9,945.43
Rate for Payer: Buckeye Health Medicaid OOS	$2,143.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,945.43
Rate for Payer: Managed Health Services Medicaid	$9,945.43
Rate for Payer: MDWise Medicaid	$9,945.43
Rate for Payer: Molina Healthcare of OH Medicare	$2,143.51

INPATIENT APRDRG 4703: CHRONIC KIDNEY DISEASE

Facility

$16,972.85

Service Code	APR-DRG 4703
Hospital Charge Code	APRDRG 4703
Min. Negotiated Rate	$3,033.07
Max. Negotiated Rate	$16,972.85
Rate for Payer: Buckeye Health Medicaid OOS	$3,033.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,972.85
Rate for Payer: Managed Health Services Medicaid	$16,972.85
Rate for Payer: MDWise Medicaid	$16,972.85
Rate for Payer: Molina Healthcare of OH Medicare	$3,033.07

INPATIENT APRDRG 4704: CHRONIC KIDNEY DISEASE

Facility

$18,851.18

Service Code	APR-DRG 4704
Hospital Charge Code	APRDRG 4704
Min. Negotiated Rate	$6,287.08
Max. Negotiated Rate	$18,851.18
Rate for Payer: Buckeye Health Medicaid OOS	$6,287.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,851.18
Rate for Payer: Managed Health Services Medicaid	$18,851.18
Rate for Payer: MDWise Medicaid	$18,851.18
Rate for Payer: Molina Healthcare of OH Medicare	$6,287.08

INPATIENT APRDRG 4801: MAJOR MALE PELVIC PROCEDURES

Facility

$15,278.28

Service Code	APR-DRG 4801
Hospital Charge Code	APRDRG 4801
Min. Negotiated Rate	$4,401.98
Max. Negotiated Rate	$15,278.28
Rate for Payer: Buckeye Health Medicaid OOS	$4,401.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,278.28
Rate for Payer: Managed Health Services Medicaid	$15,278.28
Rate for Payer: MDWise Medicaid	$15,278.28
Rate for Payer: Molina Healthcare of OH Medicare	$4,401.98

INPATIENT APRDRG 4802: MAJOR MALE PELVIC PROCEDURES

Facility

$19,570.20

Service Code	APR-DRG 4802
Hospital Charge Code	APRDRG 4802
Min. Negotiated Rate	$5,582.61
Max. Negotiated Rate	$19,570.20
Rate for Payer: Buckeye Health Medicaid OOS	$5,582.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,570.20
Rate for Payer: Managed Health Services Medicaid	$19,570.20
Rate for Payer: MDWise Medicaid	$19,570.20
Rate for Payer: Molina Healthcare of OH Medicare	$5,582.61

INPATIENT APRDRG 4803: MAJOR MALE PELVIC PROCEDURES

Facility

$25,924.23

Service Code	APR-DRG 4803
Hospital Charge Code	APRDRG 4803
Min. Negotiated Rate	$5,582.61
Max. Negotiated Rate	$25,924.23
Rate for Payer: Buckeye Health Medicaid OOS	$5,582.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,924.23
Rate for Payer: Managed Health Services Medicaid	$25,924.23
Rate for Payer: MDWise Medicaid	$25,924.23
Rate for Payer: Molina Healthcare of OH Medicare	$5,582.61

INPATIENT APRDRG 4804: MAJOR MALE PELVIC PROCEDURES

Facility

$25,924.23

Service Code	APR-DRG 4804
Hospital Charge Code	APRDRG 4804
Min. Negotiated Rate	$5,582.61
Max. Negotiated Rate	$25,924.23
Rate for Payer: Buckeye Health Medicaid OOS	$5,582.61
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,924.23
Rate for Payer: Managed Health Services Medicaid	$25,924.23
Rate for Payer: MDWise Medicaid	$25,924.23
Rate for Payer: Molina Healthcare of OH Medicare	$5,582.61

INPATIENT APRDRG 4821: TRANSURETHRAL PROSTATECTOMY

Facility

$9,238.74

Service Code	APR-DRG 4821
Hospital Charge Code	APRDRG 4821
Min. Negotiated Rate	$3,049.08
Max. Negotiated Rate	$9,238.74
Rate for Payer: Buckeye Health Medicaid OOS	$3,049.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,238.74
Rate for Payer: Managed Health Services Medicaid	$9,238.74
Rate for Payer: MDWise Medicaid	$9,238.74
Rate for Payer: Molina Healthcare of OH Medicare	$3,049.08

INPATIENT APRDRG 4822: TRANSURETHRAL PROSTATECTOMY

Facility

$10,291.99

Service Code	APR-DRG 4822
Hospital Charge Code	APRDRG 4822
Min. Negotiated Rate	$3,361.29
Max. Negotiated Rate	$10,291.99
Rate for Payer: Buckeye Health Medicaid OOS	$3,361.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,291.99
Rate for Payer: Managed Health Services Medicaid	$10,291.99
Rate for Payer: MDWise Medicaid	$10,291.99
Rate for Payer: Molina Healthcare of OH Medicare	$3,361.29

INPATIENT APRDRG 4823: TRANSURETHRAL PROSTATECTOMY

Facility

$14,935.41

Service Code	APR-DRG 4823
Hospital Charge Code	APRDRG 4823
Min. Negotiated Rate	$3,361.29
Max. Negotiated Rate	$14,935.41
Rate for Payer: Buckeye Health Medicaid OOS	$3,361.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,935.41
Rate for Payer: Managed Health Services Medicaid	$14,935.41
Rate for Payer: MDWise Medicaid	$14,935.41
Rate for Payer: Molina Healthcare of OH Medicare	$3,361.29

Know your out-of-pocket cost for care.

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