Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$45,984.94

Service Code	APR-DRG 6114
Min. Negotiated Rate	$40,850.27
Max. Negotiated Rate	$45,984.94
Rate for Payer: Buckeye Health Medicaid OOS	$40,850.27
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$40,850.27

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$20,085.38

Service Code	APR-DRG 6112
Min. Negotiated Rate	$13,400.62
Max. Negotiated Rate	$20,085.38
Rate for Payer: Buckeye Health Medicaid OOS	$13,400.62
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$13,400.62

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$23,468.17

Service Code	APR-DRG 6113
Min. Negotiated Rate	$21,786.81
Max. Negotiated Rate	$23,468.17
Rate for Payer: Buckeye Health Medicaid OOS	$21,786.81
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$21,786.81

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$7,002.90

Service Code	APR-DRG 6111
Min. Negotiated Rate	$6,448.46
Max. Negotiated Rate	$7,002.90
Rate for Payer: Buckeye Health Medicaid OOS	$7,002.90
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$7,002.90

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$6,871.31

Service Code	APR-DRG 6141
Min. Negotiated Rate	$5,446.70
Max. Negotiated Rate	$6,871.31
Rate for Payer: Buckeye Health Medicaid OOS	$5,446.70
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$5,446.70

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$27,017.38

Service Code	APR-DRG 6144
Min. Negotiated Rate	$17,125.42
Max. Negotiated Rate	$27,017.38
Rate for Payer: Buckeye Health Medicaid OOS	$27,017.38
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$27,017.38

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$11,910.27

Service Code	APR-DRG 6142
Min. Negotiated Rate	$10,547.58
Max. Negotiated Rate	$11,910.27
Rate for Payer: Buckeye Health Medicaid OOS	$10,547.58
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$10,547.58

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION

Facility

$18,242.13

Service Code	APR-DRG 6143
Min. Negotiated Rate	$17,125.42
Max. Negotiated Rate	$18,242.13
Rate for Payer: Buckeye Health Medicaid OOS	$18,242.13
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$18,242.13

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$22,340.58

Service Code	APR-DRG 6123
Min. Negotiated Rate	$22,305.54
Max. Negotiated Rate	$22,340.58
Rate for Payer: Buckeye Health Medicaid OOS	$22,305.54
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$22,305.54

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$32,161.48

Service Code	APR-DRG 6124
Min. Negotiated Rate	$25,089.10
Max. Negotiated Rate	$32,161.48
Rate for Payer: Buckeye Health Medicaid OOS	$32,161.48
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$32,161.48

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$16,984.47

Service Code	APR-DRG 6122
Min. Negotiated Rate	$15,605.24
Max. Negotiated Rate	$16,984.47
Rate for Payer: Buckeye Health Medicaid OOS	$15,605.24
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$15,605.24

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION

Facility

$11,698.85

Service Code	APR-DRG 6121
Min. Negotiated Rate	$10,763.72
Max. Negotiated Rate	$11,698.85
Rate for Payer: Buckeye Health Medicaid OOS	$10,763.72
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$10,763.72

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$31,713.75

Service Code	APR-DRG 6092
Min. Negotiated Rate	$23,083.65
Max. Negotiated Rate	$31,713.75
Rate for Payer: Buckeye Health Medicaid OOS	$23,083.65
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$23,083.65

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$35,360.34

Service Code	APR-DRG 6093
Min. Negotiated Rate	$31,713.75
Max. Negotiated Rate	$35,360.34
Rate for Payer: Buckeye Health Medicaid OOS	$35,360.34
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$35,360.34

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$101,931.15

Service Code	APR-DRG 6094
Min. Negotiated Rate	$60,291.36
Max. Negotiated Rate	$101,931.15
Rate for Payer: Buckeye Health Medicaid OOS	$101,931.15
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$101,931.15

APR-DRG 42.00: NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE

Facility

$31,713.75

Service Code	APR-DRG 6091
Min. Negotiated Rate	$18,544.73
Max. Negotiated Rate	$31,713.75
Rate for Payer: Buckeye Health Medicaid OOS	$18,544.73
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$18,544.73

APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$146,326.10

Service Code	APR-DRG 5884
Min. Negotiated Rate	$109,412.44
Max. Negotiated Rate	$146,326.10
Rate for Payer: Buckeye Health Medicaid OOS	$146,326.10
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$146,326.10

APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$71,585.24

Service Code	APR-DRG 5881
Min. Negotiated Rate	$47,887.76
Max. Negotiated Rate	$71,585.24
Rate for Payer: Buckeye Health Medicaid OOS	$71,585.24
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$71,585.24

APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$83,516.11

Service Code	APR-DRG 5882
Min. Negotiated Rate	$47,887.76
Max. Negotiated Rate	$83,516.11
Rate for Payer: Buckeye Health Medicaid OOS	$83,516.11
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$83,516.11

APR-DRG 42.00: NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE

Facility

$97,435.46

Service Code	APR-DRG 5883
Min. Negotiated Rate	$47,887.76
Max. Negotiated Rate	$97,435.46
Rate for Payer: Buckeye Health Medicaid OOS	$97,435.46
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$97,435.46

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$8,256.51

Service Code	APR-DRG 6264
Min. Negotiated Rate	$4,475.16
Max. Negotiated Rate	$8,256.51
Rate for Payer: Buckeye Health Medicaid OOS	$8,256.51
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$8,256.51

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$1,620.92

Service Code	APR-DRG 6261
Min. Negotiated Rate	$648.42
Max. Negotiated Rate	$1,620.92
Rate for Payer: Buckeye Health Medicaid OOS	$648.42
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$648.42

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$1,620.92

Service Code	APR-DRG 6262
Min. Negotiated Rate	$1,426.52
Max. Negotiated Rate	$1,620.92
Rate for Payer: Buckeye Health Medicaid OOS	$1,426.52
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,426.52

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM

Facility

$4,475.16

Service Code	APR-DRG 6263
Min. Negotiated Rate	$4,106.64
Max. Negotiated Rate	$4,475.16
Rate for Payer: Buckeye Health Medicaid OOS	$4,106.64
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$4,106.64

APR-DRG 42.00: NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$16,945.30

Service Code	APR-DRG 6233
Min. Negotiated Rate	$7,082.74
Max. Negotiated Rate	$16,945.30
Rate for Payer: Buckeye Health Medicaid OOS	$16,945.30
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$16,945.30

Know your out-of-pocket cost for care.

All Charges