Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 5302: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$8,850.25

Service Code	APR-DRG 5302
Hospital Charge Code	APRDRG 5302
Min. Negotiated Rate	$2,496.39
Max. Negotiated Rate	$8,850.25
Rate for Payer: Buckeye Health Medicaid OOS	$2,496.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,850.25
Rate for Payer: Managed Health Services Medicaid	$8,850.25
Rate for Payer: MDWise Medicaid	$8,850.25
Rate for Payer: Molina Healthcare of OH Medicare	$2,496.39

INPATIENT APRDRG 5303: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$11,730.04

Service Code	APR-DRG 5303
Hospital Charge Code	APRDRG 5303
Min. Negotiated Rate	$3,494.50
Max. Negotiated Rate	$11,730.04
Rate for Payer: Buckeye Health Medicaid OOS	$3,494.50
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,730.04
Rate for Payer: Managed Health Services Medicaid	$11,730.04
Rate for Payer: MDWise Medicaid	$11,730.04
Rate for Payer: Molina Healthcare of OH Medicare	$3,494.50

INPATIENT APRDRG 5304: FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

$21,997.36

Service Code	APR-DRG 5304
Hospital Charge Code	APRDRG 5304
Min. Negotiated Rate	$8,937.17
Max. Negotiated Rate	$21,997.36
Rate for Payer: Buckeye Health Medicaid OOS	$8,937.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,997.36
Rate for Payer: Managed Health Services Medicaid	$21,997.36
Rate for Payer: MDWise Medicaid	$21,997.36
Rate for Payer: Molina Healthcare of OH Medicare	$8,937.17

INPATIENT APRDRG 5311: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$7,010.15

Service Code	APR-DRG 5311
Hospital Charge Code	APRDRG 5311
Min. Negotiated Rate	$1,618.68
Max. Negotiated Rate	$7,010.15
Rate for Payer: Buckeye Health Medicaid OOS	$1,618.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,010.15
Rate for Payer: Managed Health Services Medicaid	$7,010.15
Rate for Payer: MDWise Medicaid	$7,010.15
Rate for Payer: Molina Healthcare of OH Medicare	$1,618.68

INPATIENT APRDRG 5312: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$8,878.62

Service Code	APR-DRG 5312
Hospital Charge Code	APRDRG 5312
Min. Negotiated Rate	$2,195.71
Max. Negotiated Rate	$8,878.62
Rate for Payer: Buckeye Health Medicaid OOS	$2,195.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,878.62
Rate for Payer: Managed Health Services Medicaid	$8,878.62
Rate for Payer: MDWise Medicaid	$8,878.62
Rate for Payer: Molina Healthcare of OH Medicare	$2,195.71

INPATIENT APRDRG 5313: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$10,099.60

Service Code	APR-DRG 5313
Hospital Charge Code	APRDRG 5313
Min. Negotiated Rate	$3,220.07
Max. Negotiated Rate	$10,099.60
Rate for Payer: Buckeye Health Medicaid OOS	$3,220.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,099.60
Rate for Payer: Managed Health Services Medicaid	$10,099.60
Rate for Payer: MDWise Medicaid	$10,099.60
Rate for Payer: Molina Healthcare of OH Medicare	$3,220.07

INPATIENT APRDRG 5314: FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

$12,683.39

Service Code	APR-DRG 5314
Hospital Charge Code	APRDRG 5314
Min. Negotiated Rate	$3,220.07
Max. Negotiated Rate	$12,683.39
Rate for Payer: Buckeye Health Medicaid OOS	$3,220.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,683.39
Rate for Payer: Managed Health Services Medicaid	$12,683.39
Rate for Payer: MDWise Medicaid	$12,683.39
Rate for Payer: Molina Healthcare of OH Medicare	$3,220.07

INPATIENT APRDRG 5321: MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$9,064.85

Service Code	APR-DRG 5321
Hospital Charge Code	APRDRG 5321
Min. Negotiated Rate	$1,952.02
Max. Negotiated Rate	$9,064.85
Rate for Payer: Buckeye Health Medicaid OOS	$1,952.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,064.85
Rate for Payer: Managed Health Services Medicaid	$9,064.85
Rate for Payer: MDWise Medicaid	$9,064.85
Rate for Payer: Molina Healthcare of OH Medicare	$1,952.02

INPATIENT APRDRG 5322: MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$9,064.85

Service Code	APR-DRG 5322
Hospital Charge Code	APRDRG 5322
Min. Negotiated Rate	$2,146.71
Max. Negotiated Rate	$9,064.85
Rate for Payer: Buckeye Health Medicaid OOS	$2,146.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,064.85
Rate for Payer: Managed Health Services Medicaid	$9,064.85
Rate for Payer: MDWise Medicaid	$9,064.85
Rate for Payer: Molina Healthcare of OH Medicare	$2,146.71

INPATIENT APRDRG 5323: MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$9,064.85

Service Code	APR-DRG 5323
Hospital Charge Code	APRDRG 5323
Min. Negotiated Rate	$2,953.01
Max. Negotiated Rate	$9,064.85
Rate for Payer: Buckeye Health Medicaid OOS	$2,953.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,064.85
Rate for Payer: Managed Health Services Medicaid	$9,064.85
Rate for Payer: MDWise Medicaid	$9,064.85
Rate for Payer: Molina Healthcare of OH Medicare	$2,953.01

INPATIENT APRDRG 5324: MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$11,631.37

Service Code	APR-DRG 5324
Hospital Charge Code	APRDRG 5324
Min. Negotiated Rate	$2,953.01
Max. Negotiated Rate	$11,631.37
Rate for Payer: Buckeye Health Medicaid OOS	$2,953.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,631.37
Rate for Payer: Managed Health Services Medicaid	$11,631.37
Rate for Payer: MDWise Medicaid	$11,631.37
Rate for Payer: Molina Healthcare of OH Medicare	$2,953.01

INPATIENT APRDRG 5391: CESAREAN SECTION W STERILIZATION

Facility

$2,275.76

Service Code	APR-DRG 5391
Hospital Charge Code	APRDRG 5391
Min. Negotiated Rate	$2,275.76
Max. Negotiated Rate	$2,275.76
Rate for Payer: Buckeye Health Medicaid OOS	$2,275.76
Rate for Payer: Molina Healthcare of OH Medicare	$2,275.76

INPATIENT APRDRG 5392: CESAREAN SECTION W STERILIZATION

Facility

$2,725.98

Service Code	APR-DRG 5392
Hospital Charge Code	APRDRG 5392
Min. Negotiated Rate	$2,725.98
Max. Negotiated Rate	$2,725.98
Rate for Payer: Buckeye Health Medicaid OOS	$2,725.98
Rate for Payer: Molina Healthcare of OH Medicare	$2,725.98

INPATIENT APRDRG 5393: CESAREAN SECTION W STERILIZATION

Facility

$3,412.20

Service Code	APR-DRG 5393
Hospital Charge Code	APRDRG 5393
Min. Negotiated Rate	$3,412.20
Max. Negotiated Rate	$3,412.20
Rate for Payer: Buckeye Health Medicaid OOS	$3,412.20
Rate for Payer: Molina Healthcare of OH Medicare	$3,412.20

INPATIENT APRDRG 5394: CESAREAN SECTION W STERILIZATION

Facility

$7,546.80

Service Code	APR-DRG 5394
Hospital Charge Code	APRDRG 5394
Min. Negotiated Rate	$7,546.80
Max. Negotiated Rate	$7,546.80
Rate for Payer: Buckeye Health Medicaid OOS	$7,546.80
Rate for Payer: Molina Healthcare of OH Medicare	$7,546.80

INPATIENT APRDRG 5401: CESAREAN SECTION W/O STERILIZATION

Facility

$9,098.15

Service Code	APR-DRG 5401
Hospital Charge Code	APRDRG 5401
Min. Negotiated Rate	$2,275.76
Max. Negotiated Rate	$9,098.15
Rate for Payer: Buckeye Health Medicaid OOS	$2,275.76
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,098.15
Rate for Payer: Managed Health Services Medicaid	$9,098.15
Rate for Payer: MDWise Medicaid	$9,098.15
Rate for Payer: Molina Healthcare of OH Medicare	$2,275.76

INPATIENT APRDRG 5402: CESAREAN SECTION W/O STERILIZATION

Facility

$11,649.87

Service Code	APR-DRG 5402
Hospital Charge Code	APRDRG 5402
Min. Negotiated Rate	$2,725.98
Max. Negotiated Rate	$11,649.87
Rate for Payer: Buckeye Health Medicaid OOS	$2,725.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,649.87
Rate for Payer: Managed Health Services Medicaid	$11,649.87
Rate for Payer: MDWise Medicaid	$11,649.87
Rate for Payer: Molina Healthcare of OH Medicare	$2,725.98

INPATIENT APRDRG 5403: CESAREAN SECTION W/O STERILIZATION

Facility

$14,882.38

Service Code	APR-DRG 5403
Hospital Charge Code	APRDRG 5403
Min. Negotiated Rate	$3,412.20
Max. Negotiated Rate	$14,882.38
Rate for Payer: Buckeye Health Medicaid OOS	$3,412.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,882.38
Rate for Payer: Managed Health Services Medicaid	$14,882.38
Rate for Payer: MDWise Medicaid	$14,882.38
Rate for Payer: Molina Healthcare of OH Medicare	$3,412.20

INPATIENT APRDRG 5404: CESAREAN SECTION W/O STERILIZATION

Facility

$29,594.57

Service Code	APR-DRG 5404
Hospital Charge Code	APRDRG 5404
Min. Negotiated Rate	$7,546.80
Max. Negotiated Rate	$29,594.57
Rate for Payer: Buckeye Health Medicaid OOS	$7,546.80
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$29,594.57
Rate for Payer: Managed Health Services Medicaid	$29,594.57
Rate for Payer: MDWise Medicaid	$29,594.57
Rate for Payer: Molina Healthcare of OH Medicare	$7,546.80

INPATIENT APRDRG 5411: VAGINAL DELIVERY W STERILIZATION &/OR D&C

Facility

$9,215.31

Service Code	APR-DRG 5411
Hospital Charge Code	APRDRG 5411
Min. Negotiated Rate	$2,265.51
Max. Negotiated Rate	$9,215.31
Rate for Payer: Buckeye Health Medicaid OOS	$2,265.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,215.31
Rate for Payer: Managed Health Services Medicaid	$9,215.31
Rate for Payer: MDWise Medicaid	$9,215.31
Rate for Payer: Molina Healthcare of OH Medicare	$2,265.51

INPATIENT APRDRG 5412: VAGINAL DELIVERY W STERILIZATION &/OR D&C

Facility

$10,045.33

Service Code	APR-DRG 5412
Hospital Charge Code	APRDRG 5412
Min. Negotiated Rate	$2,507.28
Max. Negotiated Rate	$10,045.33
Rate for Payer: Buckeye Health Medicaid OOS	$2,507.28
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,045.33
Rate for Payer: Managed Health Services Medicaid	$10,045.33
Rate for Payer: MDWise Medicaid	$10,045.33
Rate for Payer: Molina Healthcare of OH Medicare	$2,507.28

INPATIENT APRDRG 5413: VAGINAL DELIVERY W STERILIZATION &/OR D&C

Facility

$14,802.22

Service Code	APR-DRG 5413
Hospital Charge Code	APRDRG 5413
Min. Negotiated Rate	$3,042.99
Max. Negotiated Rate	$14,802.22
Rate for Payer: Buckeye Health Medicaid OOS	$3,042.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,802.22
Rate for Payer: Managed Health Services Medicaid	$14,802.22
Rate for Payer: MDWise Medicaid	$14,802.22
Rate for Payer: Molina Healthcare of OH Medicare	$3,042.99

INPATIENT APRDRG 5414: VAGINAL DELIVERY W STERILIZATION &/OR D&C

Facility

$22,913.71

Service Code	APR-DRG 5414
Hospital Charge Code	APRDRG 5414
Min. Negotiated Rate	$3,042.99
Max. Negotiated Rate	$22,913.71
Rate for Payer: Buckeye Health Medicaid OOS	$3,042.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,913.71
Rate for Payer: Managed Health Services Medicaid	$22,913.71
Rate for Payer: MDWise Medicaid	$22,913.71
Rate for Payer: Molina Healthcare of OH Medicare	$3,042.99

INPATIENT APRDRG 5421: VAGINAL DELIVERY W COMPLICATING PROCEDURES EXC STERILIZATION &/OR D&C

Facility

$7,880.87

Service Code	APR-DRG 5421
Hospital Charge Code	APRDRG 5421
Min. Negotiated Rate	$1,861.72
Max. Negotiated Rate	$7,880.87
Rate for Payer: Buckeye Health Medicaid OOS	$1,861.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,880.87
Rate for Payer: Managed Health Services Medicaid	$7,880.87
Rate for Payer: MDWise Medicaid	$7,880.87
Rate for Payer: Molina Healthcare of OH Medicare	$1,861.72

INPATIENT APRDRG 5422: VAGINAL DELIVERY W COMPLICATING PROCEDURES EXC STERILIZATION &/OR D&C

Facility

$8,939.05

Service Code	APR-DRG 5422
Hospital Charge Code	APRDRG 5422
Min. Negotiated Rate	$2,027.27
Max. Negotiated Rate	$8,939.05
Rate for Payer: Buckeye Health Medicaid OOS	$2,027.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,939.05
Rate for Payer: Managed Health Services Medicaid	$8,939.05
Rate for Payer: MDWise Medicaid	$8,939.05
Rate for Payer: Molina Healthcare of OH Medicare	$2,027.27

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All Charges