Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 6234: NEONATE BWT 2000-2499G W CONGENITAL/PERINATAL INFECTION

Facility

$24,843.85

Service Code	APR-DRG 6234
Hospital Charge Code	APRDRG 6234
Min. Negotiated Rate	$6,307.26
Max. Negotiated Rate	$24,843.85
Rate for Payer: Buckeye Health Medicaid OOS	$6,307.26
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,843.85
Rate for Payer: Managed Health Services Medicaid	$24,843.85
Rate for Payer: MDWise Medicaid	$24,843.85
Rate for Payer: Molina Healthcare of OH Medicare	$6,307.26

INPATIENT APRDRG 6251: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION

Facility

$34,812.71

Service Code	APR-DRG 6251
Hospital Charge Code	APRDRG 6251
Min. Negotiated Rate	$5,033.44
Max. Negotiated Rate	$34,812.71
Rate for Payer: Buckeye Health Medicaid OOS	$5,033.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,812.71
Rate for Payer: Managed Health Services Medicaid	$34,812.71
Rate for Payer: MDWise Medicaid	$34,812.71
Rate for Payer: Molina Healthcare of OH Medicare	$5,033.44

INPATIENT APRDRG 6252: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION

Facility

$34,812.71

Service Code	APR-DRG 6252
Hospital Charge Code	APRDRG 6252
Min. Negotiated Rate	$6,540.05
Max. Negotiated Rate	$34,812.71
Rate for Payer: Buckeye Health Medicaid OOS	$6,540.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,812.71
Rate for Payer: Managed Health Services Medicaid	$34,812.71
Rate for Payer: MDWise Medicaid	$34,812.71
Rate for Payer: Molina Healthcare of OH Medicare	$6,540.05

INPATIENT APRDRG 6253: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION

Facility

$34,812.71

Service Code	APR-DRG 6253
Hospital Charge Code	APRDRG 6253
Min. Negotiated Rate	$6,540.05
Max. Negotiated Rate	$34,812.71
Rate for Payer: Buckeye Health Medicaid OOS	$6,540.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,812.71
Rate for Payer: Managed Health Services Medicaid	$34,812.71
Rate for Payer: MDWise Medicaid	$34,812.71
Rate for Payer: Molina Healthcare of OH Medicare	$6,540.05

INPATIENT APRDRG 6254: NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION

Facility

$34,812.71

Service Code	APR-DRG 6254
Hospital Charge Code	APRDRG 6254
Min. Negotiated Rate	$6,540.05
Max. Negotiated Rate	$34,812.71
Rate for Payer: Buckeye Health Medicaid OOS	$6,540.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,812.71
Rate for Payer: Managed Health Services Medicaid	$34,812.71
Rate for Payer: MDWise Medicaid	$34,812.71
Rate for Payer: Molina Healthcare of OH Medicare	$6,540.05

INPATIENT APRDRG 6261: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$5,654.74

Service Code	APR-DRG 6261
Hospital Charge Code	APRDRG 6261
Min. Negotiated Rate	$848.57
Max. Negotiated Rate	$5,654.74
Rate for Payer: Buckeye Health Medicaid OOS	$848.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$5,654.74
Rate for Payer: Managed Health Services Medicaid	$5,654.74
Rate for Payer: MDWise Medicaid	$5,654.74
Rate for Payer: Molina Healthcare of OH Medicare	$848.57

INPATIENT APRDRG 6262: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$5,654.74

Service Code	APR-DRG 6262
Hospital Charge Code	APRDRG 6262
Min. Negotiated Rate	$1,012.20
Max. Negotiated Rate	$5,654.74
Rate for Payer: Buckeye Health Medicaid OOS	$1,012.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$5,654.74
Rate for Payer: Managed Health Services Medicaid	$5,654.74
Rate for Payer: MDWise Medicaid	$5,654.74
Rate for Payer: Molina Healthcare of OH Medicare	$1,012.20

INPATIENT APRDRG 6263: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$15,711.17

Service Code	APR-DRG 6263
Hospital Charge Code	APRDRG 6263
Min. Negotiated Rate	$2,324.43
Max. Negotiated Rate	$15,711.17
Rate for Payer: Buckeye Health Medicaid OOS	$2,324.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,711.17
Rate for Payer: Managed Health Services Medicaid	$15,711.17
Rate for Payer: MDWise Medicaid	$15,711.17
Rate for Payer: Molina Healthcare of OH Medicare	$2,324.43

INPATIENT APRDRG 6264: NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER PROBLEM

Facility

$15,711.17

Service Code	APR-DRG 6264
Hospital Charge Code	APRDRG 6264
Min. Negotiated Rate	$2,324.43
Max. Negotiated Rate	$15,711.17
Rate for Payer: Buckeye Health Medicaid OOS	$2,324.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,711.17
Rate for Payer: Managed Health Services Medicaid	$15,711.17
Rate for Payer: MDWise Medicaid	$15,711.17
Rate for Payer: Molina Healthcare of OH Medicare	$2,324.43

INPATIENT APRDRG 6301: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$48,163.32

Service Code	APR-DRG 6301
Hospital Charge Code	APRDRG 6301
Min. Negotiated Rate	$27,743.02
Max. Negotiated Rate	$48,163.32
Rate for Payer: Buckeye Health Medicaid OOS	$27,743.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$48,163.32
Rate for Payer: Managed Health Services Medicaid	$48,163.32
Rate for Payer: MDWise Medicaid	$48,163.32
Rate for Payer: Molina Healthcare of OH Medicare	$27,743.02

INPATIENT APRDRG 6302: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$48,163.32

Service Code	APR-DRG 6302
Hospital Charge Code	APRDRG 6302
Min. Negotiated Rate	$27,743.02
Max. Negotiated Rate	$48,163.32
Rate for Payer: Buckeye Health Medicaid OOS	$27,743.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$48,163.32
Rate for Payer: Managed Health Services Medicaid	$48,163.32
Rate for Payer: MDWise Medicaid	$48,163.32
Rate for Payer: Molina Healthcare of OH Medicare	$27,743.02

INPATIENT APRDRG 6303: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$48,163.32

Service Code	APR-DRG 6303
Hospital Charge Code	APRDRG 6303
Min. Negotiated Rate	$27,743.02
Max. Negotiated Rate	$48,163.32
Rate for Payer: Buckeye Health Medicaid OOS	$27,743.02
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$48,163.32
Rate for Payer: Managed Health Services Medicaid	$48,163.32
Rate for Payer: MDWise Medicaid	$48,163.32
Rate for Payer: Molina Healthcare of OH Medicare	$27,743.02

INPATIENT APRDRG 6304: NEONATE BIRTHWT >2499G W MAJOR CARDIOVASCULAR PROCEDURE

Facility

$178,935.14

Service Code	APR-DRG 6304
Hospital Charge Code	APRDRG 6304
Min. Negotiated Rate	$44,531.84
Max. Negotiated Rate	$178,935.14
Rate for Payer: Buckeye Health Medicaid OOS	$44,531.84
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$178,935.14
Rate for Payer: Managed Health Services Medicaid	$178,935.14
Rate for Payer: MDWise Medicaid	$178,935.14
Rate for Payer: Molina Healthcare of OH Medicare	$44,531.84

INPATIENT APRDRG 6311: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$15,818.47

Service Code	APR-DRG 6311
Hospital Charge Code	APRDRG 6311
Min. Negotiated Rate	$14,080.13
Max. Negotiated Rate	$15,818.47
Rate for Payer: Buckeye Health Medicaid OOS	$14,080.13
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,818.47
Rate for Payer: Managed Health Services Medicaid	$15,818.47
Rate for Payer: MDWise Medicaid	$15,818.47
Rate for Payer: Molina Healthcare of OH Medicare	$14,080.13

INPATIENT APRDRG 6312: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$43,201.70

Service Code	APR-DRG 6312
Hospital Charge Code	APRDRG 6312
Min. Negotiated Rate	$14,080.13
Max. Negotiated Rate	$43,201.70
Rate for Payer: Buckeye Health Medicaid OOS	$14,080.13
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$43,201.70
Rate for Payer: Managed Health Services Medicaid	$43,201.70
Rate for Payer: MDWise Medicaid	$43,201.70
Rate for Payer: Molina Healthcare of OH Medicare	$14,080.13

INPATIENT APRDRG 6313: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$46,098.75

Service Code	APR-DRG 6313
Hospital Charge Code	APRDRG 6313
Min. Negotiated Rate	$25,283.14
Max. Negotiated Rate	$46,098.75
Rate for Payer: Buckeye Health Medicaid OOS	$25,283.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$46,098.75
Rate for Payer: Managed Health Services Medicaid	$46,098.75
Rate for Payer: MDWise Medicaid	$46,098.75
Rate for Payer: Molina Healthcare of OH Medicare	$25,283.14

INPATIENT APRDRG 6314: NEONATE BIRTHWT >2499G W OTHER MAJOR PROCEDURE

Facility

$180,897.34

Service Code	APR-DRG 6314
Hospital Charge Code	APRDRG 6314
Min. Negotiated Rate	$36,197.95
Max. Negotiated Rate	$180,897.34
Rate for Payer: Buckeye Health Medicaid OOS	$36,197.95
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$180,897.34
Rate for Payer: Managed Health Services Medicaid	$180,897.34
Rate for Payer: MDWise Medicaid	$180,897.34
Rate for Payer: Molina Healthcare of OH Medicare	$36,197.95

INPATIENT APRDRG 6331: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$6,262.76

Service Code	APR-DRG 6331
Hospital Charge Code	APRDRG 6331
Min. Negotiated Rate	$1,279.25
Max. Negotiated Rate	$6,262.76
Rate for Payer: Buckeye Health Medicaid OOS	$1,279.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,262.76
Rate for Payer: Managed Health Services Medicaid	$6,262.76
Rate for Payer: MDWise Medicaid	$6,262.76
Rate for Payer: Molina Healthcare of OH Medicare	$1,279.25

INPATIENT APRDRG 6332: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$24,539.22

Service Code	APR-DRG 6332
Hospital Charge Code	APRDRG 6332
Min. Negotiated Rate	$4,710.67
Max. Negotiated Rate	$24,539.22
Rate for Payer: Buckeye Health Medicaid OOS	$4,710.67
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,539.22
Rate for Payer: Managed Health Services Medicaid	$24,539.22
Rate for Payer: MDWise Medicaid	$24,539.22
Rate for Payer: Molina Healthcare of OH Medicare	$4,710.67

INPATIENT APRDRG 6333: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$47,200.10

Service Code	APR-DRG 6333
Hospital Charge Code	APRDRG 6333
Min. Negotiated Rate	$13,361.57
Max. Negotiated Rate	$47,200.10
Rate for Payer: Buckeye Health Medicaid OOS	$13,361.57
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$47,200.10
Rate for Payer: Managed Health Services Medicaid	$47,200.10
Rate for Payer: MDWise Medicaid	$47,200.10
Rate for Payer: Molina Healthcare of OH Medicare	$13,361.57

INPATIENT APRDRG 6334: NEONATE BIRTHWT >2499G W MAJOR ANOMALY

Facility

$90,997.50

Service Code	APR-DRG 6334
Hospital Charge Code	APRDRG 6334
Min. Negotiated Rate	$28,578.14
Max. Negotiated Rate	$90,997.50
Rate for Payer: Buckeye Health Medicaid OOS	$28,578.14
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$90,997.50
Rate for Payer: Managed Health Services Medicaid	$90,997.50
Rate for Payer: MDWise Medicaid	$90,997.50
Rate for Payer: Molina Healthcare of OH Medicare	$28,578.14

INPATIENT APRDRG 6341: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$12,563.75

Service Code	APR-DRG 6341
Hospital Charge Code	APRDRG 6341
Min. Negotiated Rate	$2,726.94
Max. Negotiated Rate	$12,563.75
Rate for Payer: Buckeye Health Medicaid OOS	$2,726.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,563.75
Rate for Payer: Managed Health Services Medicaid	$12,563.75
Rate for Payer: MDWise Medicaid	$12,563.75
Rate for Payer: Molina Healthcare of OH Medicare	$2,726.94

INPATIENT APRDRG 6342: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$25,670.17

Service Code	APR-DRG 6342
Hospital Charge Code	APRDRG 6342
Min. Negotiated Rate	$4,810.90
Max. Negotiated Rate	$25,670.17
Rate for Payer: Buckeye Health Medicaid OOS	$4,810.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,670.17
Rate for Payer: Managed Health Services Medicaid	$25,670.17
Rate for Payer: MDWise Medicaid	$25,670.17
Rate for Payer: Molina Healthcare of OH Medicare	$4,810.90

INPATIENT APRDRG 6343: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$35,144.47

Service Code	APR-DRG 6343
Hospital Charge Code	APRDRG 6343
Min. Negotiated Rate	$6,688.31
Max. Negotiated Rate	$35,144.47
Rate for Payer: Buckeye Health Medicaid OOS	$6,688.31
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$35,144.47
Rate for Payer: Managed Health Services Medicaid	$35,144.47
Rate for Payer: MDWise Medicaid	$35,144.47
Rate for Payer: Molina Healthcare of OH Medicare	$6,688.31

INPATIENT APRDRG 6344: NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND

Facility

$66,538.44

Service Code	APR-DRG 6344
Hospital Charge Code	APRDRG 6344
Min. Negotiated Rate	$19,746.64
Max. Negotiated Rate	$66,538.44
Rate for Payer: Buckeye Health Medicaid OOS	$19,746.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$66,538.44
Rate for Payer: Managed Health Services Medicaid	$66,538.44
Rate for Payer: MDWise Medicaid	$66,538.44
Rate for Payer: Molina Healthcare of OH Medicare	$19,746.64

Know your out-of-pocket cost for care.

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