Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 5484: POSTPARTUM & POST ABORTION DIAGNOSIS W O.R. PROCEDURE

Facility IP

$6,468.32

Service Code	APR-DRG 5484
Hospital Charge Code	APRDRG 5484
Min. Negotiated Rate	$6,468.32
Max. Negotiated Rate	$6,468.32
Rate for Payer: Buckeye Health Medicaid OOS	$6,468.32
Rate for Payer: Molina Healthcare of OH Medicare	$6,468.32

INPATIENT APRDRG 5601: VAGINAL DELIVERY

Facility IP

$7,050.85

Service Code	APR-DRG 5601
Hospital Charge Code	APRDRG 5601
Min. Negotiated Rate	$1,716.67
Max. Negotiated Rate	$7,050.85
Rate for Payer: Buckeye Health Medicaid OOS	$1,716.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,050.85
Rate for Payer: Managed Health Services Medicaid	$7,050.85
Rate for Payer: MDWise Medicaid	$7,050.85
Rate for Payer: Molina Healthcare of OH Medicare	$1,716.67

INPATIENT APRDRG 5602: VAGINAL DELIVERY

Facility IP

$8,035.03

Service Code	APR-DRG 5602
Hospital Charge Code	APRDRG 5602
Min. Negotiated Rate	$1,896.63
Max. Negotiated Rate	$8,035.03
Rate for Payer: Buckeye Health Medicaid OOS	$1,896.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,035.03
Rate for Payer: Managed Health Services Medicaid	$8,035.03
Rate for Payer: MDWise Medicaid	$8,035.03
Rate for Payer: Molina Healthcare of OH Medicare	$1,896.63

INPATIENT APRDRG 5603: VAGINAL DELIVERY

Facility IP

$10,932.08

Service Code	APR-DRG 5603
Hospital Charge Code	APRDRG 5603
Min. Negotiated Rate	$2,426.90
Max. Negotiated Rate	$10,932.08
Rate for Payer: Buckeye Health Medicaid OOS	$2,426.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,932.08
Rate for Payer: Managed Health Services Medicaid	$10,932.08
Rate for Payer: MDWise Medicaid	$10,932.08
Rate for Payer: Molina Healthcare of OH Medicare	$2,426.90

INPATIENT APRDRG 5604: VAGINAL DELIVERY

Facility IP

$19,180.48

Service Code	APR-DRG 5604
Hospital Charge Code	APRDRG 5604
Min. Negotiated Rate	$4,179.43
Max. Negotiated Rate	$19,180.48
Rate for Payer: Buckeye Health Medicaid OOS	$4,179.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,180.48
Rate for Payer: Managed Health Services Medicaid	$19,180.48
Rate for Payer: MDWise Medicaid	$19,180.48
Rate for Payer: Molina Healthcare of OH Medicare	$4,179.43

INPATIENT APRDRG 5611: POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE

Facility IP

$6,037.06

Service Code	APR-DRG 5611
Hospital Charge Code	APRDRG 5611
Min. Negotiated Rate	$1,024.04
Max. Negotiated Rate	$6,037.06
Rate for Payer: Buckeye Health Medicaid OOS	$1,024.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,037.06
Rate for Payer: Managed Health Services Medicaid	$6,037.06
Rate for Payer: MDWise Medicaid	$6,037.06
Rate for Payer: Molina Healthcare of OH Medicare	$1,024.04

INPATIENT APRDRG 5612: POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE

Facility IP

$7,695.87

Service Code	APR-DRG 5612
Hospital Charge Code	APRDRG 5612
Min. Negotiated Rate	$1,396.77
Max. Negotiated Rate	$7,695.87
Rate for Payer: Buckeye Health Medicaid OOS	$1,396.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,695.87
Rate for Payer: Managed Health Services Medicaid	$7,695.87
Rate for Payer: MDWise Medicaid	$7,695.87
Rate for Payer: Molina Healthcare of OH Medicare	$1,396.77

INPATIENT APRDRG 5613: POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE

Facility IP

$11,647.40

Service Code	APR-DRG 5613
Hospital Charge Code	APRDRG 5613
Min. Negotiated Rate	$1,814.97
Max. Negotiated Rate	$11,647.40
Rate for Payer: Buckeye Health Medicaid OOS	$1,814.97
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,647.40
Rate for Payer: Managed Health Services Medicaid	$11,647.40
Rate for Payer: MDWise Medicaid	$11,647.40
Rate for Payer: Molina Healthcare of OH Medicare	$1,814.97

INPATIENT APRDRG 5614: POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE

Facility IP

$16,256.29

Service Code	APR-DRG 5614
Hospital Charge Code	APRDRG 5614
Min. Negotiated Rate	$4,240.59
Max. Negotiated Rate	$16,256.29
Rate for Payer: Buckeye Health Medicaid OOS	$4,240.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,256.29
Rate for Payer: Managed Health Services Medicaid	$16,256.29
Rate for Payer: MDWise Medicaid	$16,256.29
Rate for Payer: Molina Healthcare of OH Medicare	$4,240.59

Inpatient APRDRG 5631: PRETERM LABOR

Facility IP

$5,532.64

Service Code	APR-DRG 5631
Hospital Charge Code	APRDRG 5631
Min. Negotiated Rate	$5,532.64
Max. Negotiated Rate	$5,532.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$5,532.64
Rate for Payer: Managed Health Services Medicaid	$5,532.64
Rate for Payer: MDWise Medicaid	$5,532.64

Inpatient APRDRG 5632: PRETERM LABOR

Facility IP

$9,413.87

Service Code	APR-DRG 5632
Hospital Charge Code	APRDRG 5632
Min. Negotiated Rate	$9,413.87
Max. Negotiated Rate	$9,413.87
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,413.87
Rate for Payer: Managed Health Services Medicaid	$9,413.87
Rate for Payer: MDWise Medicaid	$9,413.87

Inpatient APRDRG 5633: PRETERM LABOR

Facility IP

$9,413.87

Service Code	APR-DRG 5633
Hospital Charge Code	APRDRG 5633
Min. Negotiated Rate	$9,413.87
Max. Negotiated Rate	$9,413.87
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,413.87
Rate for Payer: Managed Health Services Medicaid	$9,413.87
Rate for Payer: MDWise Medicaid	$9,413.87

Inpatient APRDRG 5634: PRETERM LABOR

Facility IP

$9,413.87

Service Code	APR-DRG 5634
Hospital Charge Code	APRDRG 5634
Min. Negotiated Rate	$9,413.87
Max. Negotiated Rate	$9,413.87
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,413.87
Rate for Payer: Managed Health Services Medicaid	$9,413.87
Rate for Payer: MDWise Medicaid	$9,413.87

INPATIENT APRDRG 5641: ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility IP

$3,810.94

Service Code	APR-DRG 5641
Hospital Charge Code	APRDRG 5641
Min. Negotiated Rate	$1,246.27
Max. Negotiated Rate	$3,810.94
Rate for Payer: Buckeye Health Medicaid OOS	$1,246.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$3,810.94
Rate for Payer: Managed Health Services Medicaid	$3,810.94
Rate for Payer: MDWise Medicaid	$3,810.94
Rate for Payer: Molina Healthcare of OH Medicare	$1,246.27

INPATIENT APRDRG 5642: ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility IP

$8,199.06

Service Code	APR-DRG 5642
Hospital Charge Code	APRDRG 5642
Min. Negotiated Rate	$1,536.39
Max. Negotiated Rate	$8,199.06
Rate for Payer: Buckeye Health Medicaid OOS	$1,536.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,199.06
Rate for Payer: Managed Health Services Medicaid	$8,199.06
Rate for Payer: MDWise Medicaid	$8,199.06
Rate for Payer: Molina Healthcare of OH Medicare	$1,536.39

INPATIENT APRDRG 5643: ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility IP

$8,199.06

Service Code	APR-DRG 5643
Hospital Charge Code	APRDRG 5643
Min. Negotiated Rate	$1,847.63
Max. Negotiated Rate	$8,199.06
Rate for Payer: Buckeye Health Medicaid OOS	$1,847.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,199.06
Rate for Payer: Managed Health Services Medicaid	$8,199.06
Rate for Payer: MDWise Medicaid	$8,199.06
Rate for Payer: Molina Healthcare of OH Medicare	$1,847.63

INPATIENT APRDRG 5644: ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY

Facility IP

$8,199.06

Service Code	APR-DRG 5644
Hospital Charge Code	APRDRG 5644
Min. Negotiated Rate	$1,941.14
Max. Negotiated Rate	$8,199.06
Rate for Payer: Buckeye Health Medicaid OOS	$1,941.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,199.06
Rate for Payer: Managed Health Services Medicaid	$8,199.06
Rate for Payer: MDWise Medicaid	$8,199.06
Rate for Payer: Molina Healthcare of OH Medicare	$1,941.14

Inpatient APRDRG 5651: FALSE LABOR

Facility IP

$1,861.07

Service Code	APR-DRG 5651
Hospital Charge Code	APRDRG 5651
Min. Negotiated Rate	$1,861.07
Max. Negotiated Rate	$1,861.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$1,861.07
Rate for Payer: Managed Health Services Medicaid	$1,861.07
Rate for Payer: MDWise Medicaid	$1,861.07

Inpatient APRDRG 5652: FALSE LABOR

Facility IP

$7,142.11

Service Code	APR-DRG 5652
Hospital Charge Code	APRDRG 5652
Min. Negotiated Rate	$7,142.11
Max. Negotiated Rate	$7,142.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,142.11
Rate for Payer: Managed Health Services Medicaid	$7,142.11
Rate for Payer: MDWise Medicaid	$7,142.11

Inpatient APRDRG 5653: FALSE LABOR

Facility IP

$7,142.11

Service Code	APR-DRG 5653
Hospital Charge Code	APRDRG 5653
Min. Negotiated Rate	$7,142.11
Max. Negotiated Rate	$7,142.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,142.11
Rate for Payer: Managed Health Services Medicaid	$7,142.11
Rate for Payer: MDWise Medicaid	$7,142.11

Inpatient APRDRG 5654: FALSE LABOR

Facility IP

$7,142.11

Service Code	APR-DRG 5654
Hospital Charge Code	APRDRG 5654
Min. Negotiated Rate	$7,142.11
Max. Negotiated Rate	$7,142.11
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,142.11
Rate for Payer: Managed Health Services Medicaid	$7,142.11
Rate for Payer: MDWise Medicaid	$7,142.11

INPATIENT APRDRG 5661: OTHER ANTEPARTUM DIAGNOSES

Facility IP

$6,125.86

Service Code	APR-DRG 5661
Hospital Charge Code	APRDRG 5661
Min. Negotiated Rate	$1,194.72
Max. Negotiated Rate	$6,125.86
Rate for Payer: Buckeye Health Medicaid OOS	$1,194.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,125.86
Rate for Payer: Managed Health Services Medicaid	$6,125.86
Rate for Payer: MDWise Medicaid	$6,125.86
Rate for Payer: Molina Healthcare of OH Medicare	$1,194.72

INPATIENT APRDRG 5662: OTHER ANTEPARTUM DIAGNOSES

Facility IP

$8,122.60

Service Code	APR-DRG 5662
Hospital Charge Code	APRDRG 5662
Min. Negotiated Rate	$1,554.96
Max. Negotiated Rate	$8,122.60
Rate for Payer: Buckeye Health Medicaid OOS	$1,554.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,122.60
Rate for Payer: Managed Health Services Medicaid	$8,122.60
Rate for Payer: MDWise Medicaid	$8,122.60
Rate for Payer: Molina Healthcare of OH Medicare	$1,554.96

INPATIENT APRDRG 5663: OTHER ANTEPARTUM DIAGNOSES

Facility IP

$9,289.31

Service Code	APR-DRG 5663
Hospital Charge Code	APRDRG 5663
Min. Negotiated Rate	$1,928.65
Max. Negotiated Rate	$9,289.31
Rate for Payer: Buckeye Health Medicaid OOS	$1,928.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,289.31
Rate for Payer: Managed Health Services Medicaid	$9,289.31
Rate for Payer: MDWise Medicaid	$9,289.31
Rate for Payer: Molina Healthcare of OH Medicare	$1,928.65

INPATIENT APRDRG 5664: OTHER ANTEPARTUM DIAGNOSES

Facility IP

$16,414.16

Service Code	APR-DRG 5664
Hospital Charge Code	APRDRG 5664
Min. Negotiated Rate	$5,377.67
Max. Negotiated Rate	$16,414.16
Rate for Payer: Buckeye Health Medicaid OOS	$5,377.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,414.16
Rate for Payer: Managed Health Services Medicaid	$16,414.16
Rate for Payer: MDWise Medicaid	$16,414.16
Rate for Payer: Molina Healthcare of OH Medicare	$5,377.67

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