Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 5801: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE

Facility

$3,154.81

Service Code	APR-DRG 5801
Hospital Charge Code	APRDRG 5801
Min. Negotiated Rate	$1,175.83
Max. Negotiated Rate	$3,154.81
Rate for Payer: Buckeye Health Medicaid OOS	$1,175.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$3,154.81
Rate for Payer: Managed Health Services Medicaid	$3,154.81
Rate for Payer: MDWise Medicaid	$3,154.81
Rate for Payer: Molina Healthcare of OH Medicare	$1,175.83

INPATIENT APRDRG 5802: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE

Facility

$4,000.87

Service Code	APR-DRG 5802
Hospital Charge Code	APRDRG 5802
Min. Negotiated Rate	$1,743.57
Max. Negotiated Rate	$4,000.87
Rate for Payer: Buckeye Health Medicaid OOS	$1,743.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$4,000.87
Rate for Payer: Managed Health Services Medicaid	$4,000.87
Rate for Payer: MDWise Medicaid	$4,000.87
Rate for Payer: Molina Healthcare of OH Medicare	$1,743.57

INPATIENT APRDRG 5803: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE

Facility

$6,867.08

Service Code	APR-DRG 5803
Hospital Charge Code	APRDRG 5803
Min. Negotiated Rate	$1,743.57
Max. Negotiated Rate	$6,867.08
Rate for Payer: Buckeye Health Medicaid OOS	$1,743.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,867.08
Rate for Payer: Managed Health Services Medicaid	$6,867.08
Rate for Payer: MDWise Medicaid	$6,867.08
Rate for Payer: Molina Healthcare of OH Medicare	$1,743.57

INPATIENT APRDRG 5804: NEONATE, TRANSFERRED <5 DAYS OLD, NOT BORN HERE

Facility

$6,867.08

Service Code	APR-DRG 5804
Hospital Charge Code	APRDRG 5804
Min. Negotiated Rate	$1,743.57
Max. Negotiated Rate	$6,867.08
Rate for Payer: Buckeye Health Medicaid OOS	$1,743.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,867.08
Rate for Payer: Managed Health Services Medicaid	$6,867.08
Rate for Payer: MDWise Medicaid	$6,867.08
Rate for Payer: Molina Healthcare of OH Medicare	$1,743.57

INPATIENT APRDRG 5811: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$2,497.46

Service Code	APR-DRG 5811
Hospital Charge Code	APRDRG 5811
Min. Negotiated Rate	$634.34
Max. Negotiated Rate	$2,497.46
Rate for Payer: Buckeye Health Medicaid OOS	$634.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$2,497.46
Rate for Payer: Managed Health Services Medicaid	$2,497.46
Rate for Payer: MDWise Medicaid	$2,497.46
Rate for Payer: Molina Healthcare of OH Medicare	$634.34

INPATIENT APRDRG 5812: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$3,390.38

Service Code	APR-DRG 5812
Hospital Charge Code	APRDRG 5812
Min. Negotiated Rate	$714.08
Max. Negotiated Rate	$3,390.38
Rate for Payer: Buckeye Health Medicaid OOS	$714.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$3,390.38
Rate for Payer: Managed Health Services Medicaid	$3,390.38
Rate for Payer: MDWise Medicaid	$3,390.38
Rate for Payer: Molina Healthcare of OH Medicare	$714.08

INPATIENT APRDRG 5813: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$4,115.56

Service Code	APR-DRG 5813
Hospital Charge Code	APRDRG 5813
Min. Negotiated Rate	$1,061.83
Max. Negotiated Rate	$4,115.56
Rate for Payer: Buckeye Health Medicaid OOS	$1,061.83
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$4,115.56
Rate for Payer: Managed Health Services Medicaid	$4,115.56
Rate for Payer: MDWise Medicaid	$4,115.56
Rate for Payer: Molina Healthcare of OH Medicare	$1,061.83

INPATIENT APRDRG 5814: NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$8,122.60

Service Code	APR-DRG 5814
Hospital Charge Code	APRDRG 5814
Min. Negotiated Rate	$1,468.18
Max. Negotiated Rate	$8,122.60
Rate for Payer: Buckeye Health Medicaid OOS	$1,468.18
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	$1,468.18

INPATIENT APRDRG 5831: NEONATE W ECMO

Facility

$188,848.51

Service Code	APR-DRG 5831
Hospital Charge Code	APRDRG 5831
Min. Negotiated Rate	$47,945.00
Max. Negotiated Rate	$188,848.51
Rate for Payer: Buckeye Health Medicaid OOS	$47,945.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$188,848.51
Rate for Payer: Managed Health Services Medicaid	$188,848.51
Rate for Payer: MDWise Medicaid	$188,848.51
Rate for Payer: Molina Healthcare of OH Medicare	$47,945.00

INPATIENT APRDRG 5832: NEONATE W ECMO

Facility

$188,848.51

Service Code	APR-DRG 5832
Hospital Charge Code	APRDRG 5832
Min. Negotiated Rate	$47,945.00
Max. Negotiated Rate	$188,848.51
Rate for Payer: Buckeye Health Medicaid OOS	$47,945.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$188,848.51
Rate for Payer: Managed Health Services Medicaid	$188,848.51
Rate for Payer: MDWise Medicaid	$188,848.51
Rate for Payer: Molina Healthcare of OH Medicare	$47,945.00

INPATIENT APRDRG 5833: NEONATE W ECMO

Facility

$188,848.51

Service Code	APR-DRG 5833
Hospital Charge Code	APRDRG 5833
Min. Negotiated Rate	$47,945.00
Max. Negotiated Rate	$188,848.51
Rate for Payer: Buckeye Health Medicaid OOS	$47,945.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$188,848.51
Rate for Payer: Managed Health Services Medicaid	$188,848.51
Rate for Payer: MDWise Medicaid	$188,848.51
Rate for Payer: Molina Healthcare of OH Medicare	$47,945.00

INPATIENT APRDRG 5834: NEONATE W ECMO

Facility

$188,848.51

Service Code	APR-DRG 5834
Hospital Charge Code	APRDRG 5834
Min. Negotiated Rate	$47,945.00
Max. Negotiated Rate	$188,848.51
Rate for Payer: Buckeye Health Medicaid OOS	$47,945.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$188,848.51
Rate for Payer: Managed Health Services Medicaid	$188,848.51
Rate for Payer: MDWise Medicaid	$188,848.51
Rate for Payer: Molina Healthcare of OH Medicare	$47,945.00

INPATIENT APRDRG 5881: NEONATE BWT <1500G W MAJOR PROCEDURE

Facility

$167,639.23

Service Code	APR-DRG 5881
Hospital Charge Code	APRDRG 5881
Min. Negotiated Rate	$47,122.37
Max. Negotiated Rate	$167,639.23
Rate for Payer: Buckeye Health Medicaid OOS	$47,122.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$167,639.23
Rate for Payer: Managed Health Services Medicaid	$167,639.23
Rate for Payer: MDWise Medicaid	$167,639.23
Rate for Payer: Molina Healthcare of OH Medicare	$47,122.37

INPATIENT APRDRG 5882: NEONATE BWT <1500G W MAJOR PROCEDURE

Facility

$167,639.23

Service Code	APR-DRG 5882
Hospital Charge Code	APRDRG 5882
Min. Negotiated Rate	$47,122.37
Max. Negotiated Rate	$167,639.23
Rate for Payer: Buckeye Health Medicaid OOS	$47,122.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$167,639.23
Rate for Payer: Managed Health Services Medicaid	$167,639.23
Rate for Payer: MDWise Medicaid	$167,639.23
Rate for Payer: Molina Healthcare of OH Medicare	$47,122.37

INPATIENT APRDRG 5883: NEONATE BWT <1500G W MAJOR PROCEDURE

Facility

$167,639.23

Service Code	APR-DRG 5883
Hospital Charge Code	APRDRG 5883
Min. Negotiated Rate	$47,122.37
Max. Negotiated Rate	$167,639.23
Rate for Payer: Buckeye Health Medicaid OOS	$47,122.37
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$167,639.23
Rate for Payer: Managed Health Services Medicaid	$167,639.23
Rate for Payer: MDWise Medicaid	$167,639.23
Rate for Payer: Molina Healthcare of OH Medicare	$47,122.37

INPATIENT APRDRG 5884: NEONATE BWT <1500G W MAJOR PROCEDURE

Facility

$382,913.93

Service Code	APR-DRG 5884
Hospital Charge Code	APRDRG 5884
Min. Negotiated Rate	$94,822.41
Max. Negotiated Rate	$382,913.93
Rate for Payer: Buckeye Health Medicaid OOS	$94,822.41
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$382,913.93
Rate for Payer: Managed Health Services Medicaid	$382,913.93
Rate for Payer: MDWise Medicaid	$382,913.93
Rate for Payer: Molina Healthcare of OH Medicare	$94,822.41

INPATIENT APRDRG 5891: NEONATE BWT <500G OR GA <24 WEEKS

Facility

$64,600.91

Service Code	APR-DRG 5891
Hospital Charge Code	APRDRG 5891
Min. Negotiated Rate	$16,400.72
Max. Negotiated Rate	$64,600.91
Rate for Payer: Buckeye Health Medicaid OOS	$16,400.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$64,600.91
Rate for Payer: Managed Health Services Medicaid	$64,600.91
Rate for Payer: MDWise Medicaid	$64,600.91
Rate for Payer: Molina Healthcare of OH Medicare	$16,400.72

INPATIENT APRDRG 5892: NEONATE BWT <500G OR GA <24 WEEKS

Facility

$64,600.91

Service Code	APR-DRG 5892
Hospital Charge Code	APRDRG 5892
Min. Negotiated Rate	$16,400.72
Max. Negotiated Rate	$64,600.91
Rate for Payer: Buckeye Health Medicaid OOS	$16,400.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$64,600.91
Rate for Payer: Managed Health Services Medicaid	$64,600.91
Rate for Payer: MDWise Medicaid	$64,600.91
Rate for Payer: Molina Healthcare of OH Medicare	$16,400.72

INPATIENT APRDRG 5893: NEONATE BWT <500G OR GA <24 WEEKS

Facility

$64,600.91

Service Code	APR-DRG 5893
Hospital Charge Code	APRDRG 5893
Min. Negotiated Rate	$16,400.72
Max. Negotiated Rate	$64,600.91
Rate for Payer: Buckeye Health Medicaid OOS	$16,400.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$64,600.91
Rate for Payer: Managed Health Services Medicaid	$64,600.91
Rate for Payer: MDWise Medicaid	$64,600.91
Rate for Payer: Molina Healthcare of OH Medicare	$16,400.72

INPATIENT APRDRG 5894: NEONATE BWT <500G OR GA <24 WEEKS

Facility

$64,600.91

Service Code	APR-DRG 5894
Hospital Charge Code	APRDRG 5894
Min. Negotiated Rate	$16,400.72
Max. Negotiated Rate	$64,600.91
Rate for Payer: Buckeye Health Medicaid OOS	$16,400.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$64,600.91
Rate for Payer: Managed Health Services Medicaid	$64,600.91
Rate for Payer: MDWise Medicaid	$64,600.91
Rate for Payer: Molina Healthcare of OH Medicare	$16,400.72

INPATIENT APRDRG 5911: NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE

Facility

$101,865.45

Service Code	APR-DRG 5911
Hospital Charge Code	APRDRG 5911
Min. Negotiated Rate	$25,861.44
Max. Negotiated Rate	$101,865.45
Rate for Payer: Buckeye Health Medicaid OOS	$25,861.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$101,865.45
Rate for Payer: Managed Health Services Medicaid	$101,865.45
Rate for Payer: MDWise Medicaid	$101,865.45
Rate for Payer: Molina Healthcare of OH Medicare	$25,861.44

INPATIENT APRDRG 5912: NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE

Facility

$101,865.45

Service Code	APR-DRG 5912
Hospital Charge Code	APRDRG 5912
Min. Negotiated Rate	$25,861.44
Max. Negotiated Rate	$101,865.45
Rate for Payer: Buckeye Health Medicaid OOS	$25,861.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$101,865.45
Rate for Payer: Managed Health Services Medicaid	$101,865.45
Rate for Payer: MDWise Medicaid	$101,865.45
Rate for Payer: Molina Healthcare of OH Medicare	$25,861.44

INPATIENT APRDRG 5913: NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE

Facility

$101,865.45

Service Code	APR-DRG 5913
Hospital Charge Code	APRDRG 5913
Min. Negotiated Rate	$25,861.44
Max. Negotiated Rate	$101,865.45
Rate for Payer: Buckeye Health Medicaid OOS	$25,861.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$101,865.45
Rate for Payer: Managed Health Services Medicaid	$101,865.45
Rate for Payer: MDWise Medicaid	$101,865.45
Rate for Payer: Molina Healthcare of OH Medicare	$25,861.44

INPATIENT APRDRG 5914: NEONATE BIRTHWT 500-749G W/O MAJOR PROCEDURE

Facility

$222,706.64

Service Code	APR-DRG 5914
Hospital Charge Code	APRDRG 5914
Min. Negotiated Rate	$44,676.58
Max. Negotiated Rate	$222,706.64
Rate for Payer: Buckeye Health Medicaid OOS	$44,676.58
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$222,706.64
Rate for Payer: Managed Health Services Medicaid	$222,706.64
Rate for Payer: MDWise Medicaid	$222,706.64
Rate for Payer: Molina Healthcare of OH Medicare	$44,676.58

INPATIENT APRDRG 5931: NEONATE BIRTHWT 750-999G W/O MAJOR PROCEDURE

Facility

$99,497.49

Service Code	APR-DRG 5931
Hospital Charge Code	APRDRG 5931
Min. Negotiated Rate	$28,272.65
Max. Negotiated Rate	$99,497.49
Rate for Payer: Buckeye Health Medicaid OOS	$28,272.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$99,497.49
Rate for Payer: Managed Health Services Medicaid	$99,497.49
Rate for Payer: MDWise Medicaid	$99,497.49
Rate for Payer: Molina Healthcare of OH Medicare	$28,272.65

Know your out-of-pocket cost for care.

All Charges