Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 6612: COAGULATION & PLATELET DISORDERS

Facility

$11,837.33

Service Code	APR-DRG 6612
Hospital Charge Code	APRDRG 6612
Min. Negotiated Rate	$3,702.63
Max. Negotiated Rate	$11,837.33
Rate for Payer: Buckeye Health Medicaid OOS	$3,702.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,837.33
Rate for Payer: Managed Health Services Medicaid	$11,837.33
Rate for Payer: MDWise Medicaid	$11,837.33
Rate for Payer: Molina Healthcare of OH Medicare	$3,702.63

INPATIENT APRDRG 6613: COAGULATION & PLATELET DISORDERS

Facility

$15,035.31

Service Code	APR-DRG 6613
Hospital Charge Code	APRDRG 6613
Min. Negotiated Rate	$7,336.74
Max. Negotiated Rate	$15,035.31
Rate for Payer: Buckeye Health Medicaid OOS	$7,336.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,035.31
Rate for Payer: Managed Health Services Medicaid	$15,035.31
Rate for Payer: MDWise Medicaid	$15,035.31
Rate for Payer: Molina Healthcare of OH Medicare	$7,336.74

INPATIENT APRDRG 6614: COAGULATION & PLATELET DISORDERS

Facility

$39,721.30

Service Code	APR-DRG 6614
Hospital Charge Code	APRDRG 6614
Min. Negotiated Rate	$13,547.29
Max. Negotiated Rate	$39,721.30
Rate for Payer: Buckeye Health Medicaid OOS	$13,547.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$39,721.30
Rate for Payer: Managed Health Services Medicaid	$39,721.30
Rate for Payer: MDWise Medicaid	$39,721.30
Rate for Payer: Molina Healthcare of OH Medicare	$13,547.29

INPATIENT APRDRG 6621: SICKLE CELL ANEMIA CRISIS

Facility

$10,213.06

Service Code	APR-DRG 6621
Hospital Charge Code	APRDRG 6621
Min. Negotiated Rate	$2,498.63
Max. Negotiated Rate	$10,213.06
Rate for Payer: Buckeye Health Medicaid OOS	$2,498.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,213.06
Rate for Payer: Managed Health Services Medicaid	$10,213.06
Rate for Payer: MDWise Medicaid	$10,213.06
Rate for Payer: Molina Healthcare of OH Medicare	$2,498.63

INPATIENT APRDRG 6622: SICKLE CELL ANEMIA CRISIS

Facility

$12,618.02

Service Code	APR-DRG 6622
Hospital Charge Code	APRDRG 6622
Min. Negotiated Rate	$2,953.33
Max. Negotiated Rate	$12,618.02
Rate for Payer: Buckeye Health Medicaid OOS	$2,953.33
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,618.02
Rate for Payer: Managed Health Services Medicaid	$12,618.02
Rate for Payer: MDWise Medicaid	$12,618.02
Rate for Payer: Molina Healthcare of OH Medicare	$2,953.33

INPATIENT APRDRG 6623: SICKLE CELL ANEMIA CRISIS

Facility

$20,021.60

Service Code	APR-DRG 6623
Hospital Charge Code	APRDRG 6623
Min. Negotiated Rate	$4,151.25
Max. Negotiated Rate	$20,021.60
Rate for Payer: Buckeye Health Medicaid OOS	$4,151.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,021.60
Rate for Payer: Managed Health Services Medicaid	$20,021.60
Rate for Payer: MDWise Medicaid	$20,021.60
Rate for Payer: Molina Healthcare of OH Medicare	$4,151.25

INPATIENT APRDRG 6624: SICKLE CELL ANEMIA CRISIS

Facility

$25,853.93

Service Code	APR-DRG 6624
Hospital Charge Code	APRDRG 6624
Min. Negotiated Rate	$6,669.74
Max. Negotiated Rate	$25,853.93
Rate for Payer: Buckeye Health Medicaid OOS	$6,669.74
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,853.93
Rate for Payer: Managed Health Services Medicaid	$25,853.93
Rate for Payer: MDWise Medicaid	$25,853.93
Rate for Payer: Molina Healthcare of OH Medicare	$6,669.74

INPATIENT APRDRG 6631: OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS

Facility

$8,529.59

Service Code	APR-DRG 6631
Hospital Charge Code	APRDRG 6631
Min. Negotiated Rate	$1,872.29
Max. Negotiated Rate	$8,529.59
Rate for Payer: Buckeye Health Medicaid OOS	$1,872.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,529.59
Rate for Payer: Managed Health Services Medicaid	$8,529.59
Rate for Payer: MDWise Medicaid	$8,529.59
Rate for Payer: Molina Healthcare of OH Medicare	$1,872.29

INPATIENT APRDRG 6632: OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS

Facility

$10,814.92

Service Code	APR-DRG 6632
Hospital Charge Code	APRDRG 6632
Min. Negotiated Rate	$2,162.08
Max. Negotiated Rate	$10,814.92
Rate for Payer: Buckeye Health Medicaid OOS	$2,162.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,814.92
Rate for Payer: Managed Health Services Medicaid	$10,814.92
Rate for Payer: MDWise Medicaid	$10,814.92
Rate for Payer: Molina Healthcare of OH Medicare	$2,162.08

INPATIENT APRDRG 6633: OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS

Facility

$12,746.28

Service Code	APR-DRG 6633
Hospital Charge Code	APRDRG 6633
Min. Negotiated Rate	$3,049.08
Max. Negotiated Rate	$12,746.28
Rate for Payer: Buckeye Health Medicaid OOS	$3,049.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$12,746.28
Rate for Payer: Managed Health Services Medicaid	$12,746.28
Rate for Payer: MDWise Medicaid	$12,746.28
Rate for Payer: Molina Healthcare of OH Medicare	$3,049.08

INPATIENT APRDRG 6634: OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS

Facility

$16,708.92

Service Code	APR-DRG 6634
Hospital Charge Code	APRDRG 6634
Min. Negotiated Rate	$5,643.77
Max. Negotiated Rate	$16,708.92
Rate for Payer: Buckeye Health Medicaid OOS	$5,643.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$16,708.92
Rate for Payer: Managed Health Services Medicaid	$16,708.92
Rate for Payer: MDWise Medicaid	$16,708.92
Rate for Payer: Molina Healthcare of OH Medicare	$5,643.77

INPATIENT APRDRG 6801: MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$19,075.64

Service Code	APR-DRG 6801
Hospital Charge Code	APRDRG 6801
Min. Negotiated Rate	$5,289.29
Max. Negotiated Rate	$19,075.64
Rate for Payer: Buckeye Health Medicaid OOS	$5,289.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,075.64
Rate for Payer: Managed Health Services Medicaid	$19,075.64
Rate for Payer: MDWise Medicaid	$19,075.64
Rate for Payer: Molina Healthcare of OH Medicare	$5,289.29

INPATIENT APRDRG 6802: MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$34,831.21

Service Code	APR-DRG 6802
Hospital Charge Code	APRDRG 6802
Min. Negotiated Rate	$8,455.89
Max. Negotiated Rate	$34,831.21
Rate for Payer: Buckeye Health Medicaid OOS	$8,455.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,831.21
Rate for Payer: Managed Health Services Medicaid	$34,831.21
Rate for Payer: MDWise Medicaid	$34,831.21
Rate for Payer: Molina Healthcare of OH Medicare	$8,455.89

INPATIENT APRDRG 6803: MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$45,219.40

Service Code	APR-DRG 6803
Hospital Charge Code	APRDRG 6803
Min. Negotiated Rate	$15,190.63
Max. Negotiated Rate	$45,219.40
Rate for Payer: Buckeye Health Medicaid OOS	$15,190.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$45,219.40
Rate for Payer: Managed Health Services Medicaid	$45,219.40
Rate for Payer: MDWise Medicaid	$45,219.40
Rate for Payer: Molina Healthcare of OH Medicare	$15,190.63

INPATIENT APRDRG 6804: MAJOR O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$65,241.00

Service Code	APR-DRG 6804
Hospital Charge Code	APRDRG 6804
Min. Negotiated Rate	$15,190.63
Max. Negotiated Rate	$65,241.00
Rate for Payer: Buckeye Health Medicaid OOS	$15,190.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$65,241.00
Rate for Payer: Managed Health Services Medicaid	$65,241.00
Rate for Payer: MDWise Medicaid	$65,241.00
Rate for Payer: Molina Healthcare of OH Medicare	$15,190.63

INPATIENT APRDRG 6811: OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$14,427.29

Service Code	APR-DRG 6811
Hospital Charge Code	APRDRG 6811
Min. Negotiated Rate	$4,214.66
Max. Negotiated Rate	$14,427.29
Rate for Payer: Buckeye Health Medicaid OOS	$4,214.66
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,427.29
Rate for Payer: Managed Health Services Medicaid	$14,427.29
Rate for Payer: MDWise Medicaid	$14,427.29
Rate for Payer: Molina Healthcare of OH Medicare	$4,214.66

INPATIENT APRDRG 6812: OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$18,995.48

Service Code	APR-DRG 6812
Hospital Charge Code	APRDRG 6812
Min. Negotiated Rate	$5,508.64
Max. Negotiated Rate	$18,995.48
Rate for Payer: Buckeye Health Medicaid OOS	$5,508.64
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,995.48
Rate for Payer: Managed Health Services Medicaid	$18,995.48
Rate for Payer: MDWise Medicaid	$18,995.48
Rate for Payer: Molina Healthcare of OH Medicare	$5,508.64

INPATIENT APRDRG 6813: OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$51,235.50

Service Code	APR-DRG 6813
Hospital Charge Code	APRDRG 6813
Min. Negotiated Rate	$7,964.04
Max. Negotiated Rate	$51,235.50
Rate for Payer: Buckeye Health Medicaid OOS	$7,964.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$51,235.50
Rate for Payer: Managed Health Services Medicaid	$51,235.50
Rate for Payer: MDWise Medicaid	$51,235.50
Rate for Payer: Molina Healthcare of OH Medicare	$7,964.04

INPATIENT APRDRG 6814: OTHER O.R. PROCEDURES FOR LYMPHATIC/HEMATOPOIETIC/OTHER NEOPLASMS

Facility

$68,717.71

Service Code	APR-DRG 6814
Hospital Charge Code	APRDRG 6814
Min. Negotiated Rate	$23,380.10
Max. Negotiated Rate	$68,717.71
Rate for Payer: Buckeye Health Medicaid OOS	$23,380.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$68,717.71
Rate for Payer: Managed Health Services Medicaid	$68,717.71
Rate for Payer: MDWise Medicaid	$68,717.71
Rate for Payer: Molina Healthcare of OH Medicare	$23,380.10

INPATIENT APRDRG 6901: ACUTE LEUKEMIA

Facility

$11,672.07

Service Code	APR-DRG 6901
Hospital Charge Code	APRDRG 6901
Min. Negotiated Rate	$8,281.05
Max. Negotiated Rate	$11,672.07
Rate for Payer: Buckeye Health Medicaid OOS	$8,281.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,672.07
Rate for Payer: Managed Health Services Medicaid	$11,672.07
Rate for Payer: MDWise Medicaid	$11,672.07
Rate for Payer: Molina Healthcare of OH Medicare	$8,281.05

INPATIENT APRDRG 6902: ACUTE LEUKEMIA

Facility

$35,435.53

Service Code	APR-DRG 6902
Hospital Charge Code	APRDRG 6902
Min. Negotiated Rate	$8,281.05
Max. Negotiated Rate	$35,435.53
Rate for Payer: Buckeye Health Medicaid OOS	$8,281.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$35,435.53
Rate for Payer: Managed Health Services Medicaid	$35,435.53
Rate for Payer: MDWise Medicaid	$35,435.53
Rate for Payer: Molina Healthcare of OH Medicare	$8,281.05

INPATIENT APRDRG 6903: ACUTE LEUKEMIA

Facility

$73,161.33

Service Code	APR-DRG 6903
Hospital Charge Code	APRDRG 6903
Min. Negotiated Rate	$19,663.70
Max. Negotiated Rate	$73,161.33
Rate for Payer: Buckeye Health Medicaid OOS	$19,663.70
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$73,161.33
Rate for Payer: Managed Health Services Medicaid	$73,161.33
Rate for Payer: MDWise Medicaid	$73,161.33
Rate for Payer: Molina Healthcare of OH Medicare	$19,663.70

INPATIENT APRDRG 6904: ACUTE LEUKEMIA

Facility

$75,731.55

Service Code	APR-DRG 6904
Hospital Charge Code	APRDRG 6904
Min. Negotiated Rate	$26,190.62
Max. Negotiated Rate	$75,731.55
Rate for Payer: Buckeye Health Medicaid OOS	$26,190.62
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$75,731.55
Rate for Payer: Managed Health Services Medicaid	$75,731.55
Rate for Payer: MDWise Medicaid	$75,731.55
Rate for Payer: Molina Healthcare of OH Medicare	$26,190.62

INPATIENT APRDRG 6911: LYMPHOMA, MYELOMA & NON-ACUTE LEUKEMIA

Facility

$15,787.63

Service Code	APR-DRG 6911
Hospital Charge Code	APRDRG 6911
Min. Negotiated Rate	$4,081.77
Max. Negotiated Rate	$15,787.63
Rate for Payer: Buckeye Health Medicaid OOS	$4,081.77
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,787.63
Rate for Payer: Managed Health Services Medicaid	$15,787.63
Rate for Payer: MDWise Medicaid	$15,787.63
Rate for Payer: Molina Healthcare of OH Medicare	$4,081.77

INPATIENT APRDRG 6912: LYMPHOMA, MYELOMA & NON-ACUTE LEUKEMIA

Facility

$21,285.74

Service Code	APR-DRG 6912
Hospital Charge Code	APRDRG 6912
Min. Negotiated Rate	$4,066.08
Max. Negotiated Rate	$21,285.74
Rate for Payer: Buckeye Health Medicaid OOS	$4,066.08
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,285.74
Rate for Payer: Managed Health Services Medicaid	$21,285.74
Rate for Payer: MDWise Medicaid	$21,285.74
Rate for Payer: Molina Healthcare of OH Medicare	$4,066.08

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