Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 7934: MODERATELY EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$43,326.27

Service Code	APR-DRG 7934
Hospital Charge Code	APRDRG 7934
Min. Negotiated Rate	$12,477.78
Max. Negotiated Rate	$43,326.27
Rate for Payer: Buckeye Health Medicaid OOS	$12,477.78
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$43,326.27
Rate for Payer: Managed Health Services Medicaid	$43,326.27
Rate for Payer: MDWise Medicaid	$43,326.27
Rate for Payer: Molina Healthcare of OH Medicare	$12,477.78

INPATIENT APRDRG 7941: NON-EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$9,972.56

Service Code	APR-DRG 7941
Hospital Charge Code	APRDRG 7941
Min. Negotiated Rate	$2,790.99
Max. Negotiated Rate	$9,972.56
Rate for Payer: Buckeye Health Medicaid OOS	$2,790.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,972.56
Rate for Payer: Managed Health Services Medicaid	$9,972.56
Rate for Payer: MDWise Medicaid	$9,972.56
Rate for Payer: Molina Healthcare of OH Medicare	$2,790.99

INPATIENT APRDRG 7942: NON-EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$11,912.57

Service Code	APR-DRG 7942
Hospital Charge Code	APRDRG 7942
Min. Negotiated Rate	$5,516.65
Max. Negotiated Rate	$11,912.57
Rate for Payer: Buckeye Health Medicaid OOS	$5,516.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,912.57
Rate for Payer: Managed Health Services Medicaid	$11,912.57
Rate for Payer: MDWise Medicaid	$11,912.57
Rate for Payer: Molina Healthcare of OH Medicare	$5,516.65

INPATIENT APRDRG 7943: NON-EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$17,447.67

Service Code	APR-DRG 7943
Hospital Charge Code	APRDRG 7943
Min. Negotiated Rate	$5,516.65
Max. Negotiated Rate	$17,447.67
Rate for Payer: Buckeye Health Medicaid OOS	$5,516.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,447.67
Rate for Payer: Managed Health Services Medicaid	$17,447.67
Rate for Payer: MDWise Medicaid	$17,447.67
Rate for Payer: Molina Healthcare of OH Medicare	$5,516.65

INPATIENT APRDRG 7944: NON-EXTENSIVE OR PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility IP

$21,729.73

Service Code	APR-DRG 7944
Hospital Charge Code	APRDRG 7944
Min. Negotiated Rate	$5,516.65
Max. Negotiated Rate	$21,729.73
Rate for Payer: Buckeye Health Medicaid OOS	$5,516.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,729.73
Rate for Payer: Managed Health Services Medicaid	$21,729.73
Rate for Payer: MDWise Medicaid	$21,729.73
Rate for Payer: Molina Healthcare of OH Medicare	$5,516.65

INPATIENT APRDRG 8101: HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility IP

$7,689.70

Service Code	APR-DRG 8101
Hospital Charge Code	APRDRG 8101
Min. Negotiated Rate	$1,755.73
Max. Negotiated Rate	$7,689.70
Rate for Payer: Buckeye Health Medicaid OOS	$1,755.73
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,689.70
Rate for Payer: Managed Health Services Medicaid	$7,689.70
Rate for Payer: MDWise Medicaid	$7,689.70
Rate for Payer: Molina Healthcare of OH Medicare	$1,755.73

INPATIENT APRDRG 8102: HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility IP

$9,436.07

Service Code	APR-DRG 8102
Hospital Charge Code	APRDRG 8102
Min. Negotiated Rate	$2,074.03
Max. Negotiated Rate	$9,436.07
Rate for Payer: Buckeye Health Medicaid OOS	$2,074.03
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,436.07
Rate for Payer: Managed Health Services Medicaid	$9,436.07
Rate for Payer: MDWise Medicaid	$9,436.07
Rate for Payer: Molina Healthcare of OH Medicare	$2,074.03

INPATIENT APRDRG 8103: HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility IP

$11,820.07

Service Code	APR-DRG 8103
Hospital Charge Code	APRDRG 8103
Min. Negotiated Rate	$3,630.27
Max. Negotiated Rate	$11,820.07
Rate for Payer: Buckeye Health Medicaid OOS	$3,630.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,820.07
Rate for Payer: Managed Health Services Medicaid	$11,820.07
Rate for Payer: MDWise Medicaid	$11,820.07
Rate for Payer: Molina Healthcare of OH Medicare	$3,630.27

INPATIENT APRDRG 8104: HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility IP

$21,518.84

Service Code	APR-DRG 8104
Hospital Charge Code	APRDRG 8104
Min. Negotiated Rate	$3,630.27
Max. Negotiated Rate	$21,518.84
Rate for Payer: Buckeye Health Medicaid OOS	$3,630.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$21,518.84
Rate for Payer: Managed Health Services Medicaid	$21,518.84
Rate for Payer: MDWise Medicaid	$21,518.84
Rate for Payer: Molina Healthcare of OH Medicare	$3,630.27

INPATIENT APRDRG 8111: ALLERGIC REACTIONS

Facility IP

$5,242.81

Service Code	APR-DRG 8111
Hospital Charge Code	APRDRG 8111
Min. Negotiated Rate	$1,272.21
Max. Negotiated Rate	$5,242.81
Rate for Payer: Buckeye Health Medicaid OOS	$1,272.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$5,242.81
Rate for Payer: Managed Health Services Medicaid	$5,242.81
Rate for Payer: MDWise Medicaid	$5,242.81
Rate for Payer: Molina Healthcare of OH Medicare	$1,272.21

INPATIENT APRDRG 8112: ALLERGIC REACTIONS

Facility IP

$8,376.66

Service Code	APR-DRG 8112
Hospital Charge Code	APRDRG 8112
Min. Negotiated Rate	$1,643.34
Max. Negotiated Rate	$8,376.66
Rate for Payer: Buckeye Health Medicaid OOS	$1,643.34
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,376.66
Rate for Payer: Managed Health Services Medicaid	$8,376.66
Rate for Payer: MDWise Medicaid	$8,376.66
Rate for Payer: Molina Healthcare of OH Medicare	$1,643.34

INPATIENT APRDRG 8113: ALLERGIC REACTIONS

Facility IP

$14,428.52

Service Code	APR-DRG 8113
Hospital Charge Code	APRDRG 8113
Min. Negotiated Rate	$2,949.17
Max. Negotiated Rate	$14,428.52
Rate for Payer: Buckeye Health Medicaid OOS	$2,949.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,428.52
Rate for Payer: Managed Health Services Medicaid	$14,428.52
Rate for Payer: MDWise Medicaid	$14,428.52
Rate for Payer: Molina Healthcare of OH Medicare	$2,949.17

INPATIENT APRDRG 8114: ALLERGIC REACTIONS

Facility IP

$18,514.49

Service Code	APR-DRG 8114
Hospital Charge Code	APRDRG 8114
Min. Negotiated Rate	$5,676.75
Max. Negotiated Rate	$18,514.49
Rate for Payer: Buckeye Health Medicaid OOS	$5,676.75
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$18,514.49
Rate for Payer: Managed Health Services Medicaid	$18,514.49
Rate for Payer: MDWise Medicaid	$18,514.49
Rate for Payer: Molina Healthcare of OH Medicare	$5,676.75

INPATIENT APRDRG 8121: POISONING OF MEDICINAL AGENTS

Facility IP

$6,862.15

Service Code	APR-DRG 8121
Hospital Charge Code	APRDRG 8121
Min. Negotiated Rate	$1,310.32
Max. Negotiated Rate	$6,862.15
Rate for Payer: Buckeye Health Medicaid OOS	$1,310.32
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,862.15
Rate for Payer: Managed Health Services Medicaid	$6,862.15
Rate for Payer: MDWise Medicaid	$6,862.15
Rate for Payer: Molina Healthcare of OH Medicare	$1,310.32

INPATIENT APRDRG 8122: POISONING OF MEDICINAL AGENTS

Facility IP

$8,179.33

Service Code	APR-DRG 8122
Hospital Charge Code	APRDRG 8122
Min. Negotiated Rate	$1,614.52
Max. Negotiated Rate	$8,179.33
Rate for Payer: Buckeye Health Medicaid OOS	$1,614.52
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$8,179.33
Rate for Payer: Managed Health Services Medicaid	$8,179.33
Rate for Payer: MDWise Medicaid	$8,179.33
Rate for Payer: Molina Healthcare of OH Medicare	$1,614.52

INPATIENT APRDRG 8123: POISONING OF MEDICINAL AGENTS

Facility IP

$10,195.79

Service Code	APR-DRG 8123
Hospital Charge Code	APRDRG 8123
Min. Negotiated Rate	$2,414.09
Max. Negotiated Rate	$10,195.79
Rate for Payer: Buckeye Health Medicaid OOS	$2,414.09
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,195.79
Rate for Payer: Managed Health Services Medicaid	$10,195.79
Rate for Payer: MDWise Medicaid	$10,195.79
Rate for Payer: Molina Healthcare of OH Medicare	$2,414.09

INPATIENT APRDRG 8124: POISONING OF MEDICINAL AGENTS

Facility IP

$17,351.47

Service Code	APR-DRG 8124
Hospital Charge Code	APRDRG 8124
Min. Negotiated Rate	$4,706.51
Max. Negotiated Rate	$17,351.47
Rate for Payer: Buckeye Health Medicaid OOS	$4,706.51
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,351.47
Rate for Payer: Managed Health Services Medicaid	$17,351.47
Rate for Payer: MDWise Medicaid	$17,351.47
Rate for Payer: Molina Healthcare of OH Medicare	$4,706.51

INPATIENT APRDRG 8131: OTHER COMPLICATIONS OF TREATMENT

Facility IP

$6,345.39

Service Code	APR-DRG 8131
Hospital Charge Code	APRDRG 8131
Min. Negotiated Rate	$2,102.53
Max. Negotiated Rate	$6,345.39
Rate for Payer: Buckeye Health Medicaid OOS	$2,102.53
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$6,345.39
Rate for Payer: Managed Health Services Medicaid	$6,345.39
Rate for Payer: MDWise Medicaid	$6,345.39
Rate for Payer: Molina Healthcare of OH Medicare	$2,102.53

INPATIENT APRDRG 8132: OTHER COMPLICATIONS OF TREATMENT

Facility IP

$11,837.33

Service Code	APR-DRG 8132
Hospital Charge Code	APRDRG 8132
Min. Negotiated Rate	$2,531.29
Max. Negotiated Rate	$11,837.33
Rate for Payer: Buckeye Health Medicaid OOS	$2,531.29
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	$2,531.29

INPATIENT APRDRG 8133: OTHER COMPLICATIONS OF TREATMENT

Facility IP

$14,061.00

Service Code	APR-DRG 8133
Hospital Charge Code	APRDRG 8133
Min. Negotiated Rate	$3,343.99
Max. Negotiated Rate	$14,061.00
Rate for Payer: Buckeye Health Medicaid OOS	$3,343.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,061.00
Rate for Payer: Managed Health Services Medicaid	$14,061.00
Rate for Payer: MDWise Medicaid	$14,061.00
Rate for Payer: Molina Healthcare of OH Medicare	$3,343.99

INPATIENT APRDRG 8134: OTHER COMPLICATIONS OF TREATMENT

Facility IP

$22,071.36

Service Code	APR-DRG 8134
Hospital Charge Code	APRDRG 8134
Min. Negotiated Rate	$6,746.59
Max. Negotiated Rate	$22,071.36
Rate for Payer: Buckeye Health Medicaid OOS	$6,746.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$22,071.36
Rate for Payer: Managed Health Services Medicaid	$22,071.36
Rate for Payer: MDWise Medicaid	$22,071.36
Rate for Payer: Molina Healthcare of OH Medicare	$6,746.59

INPATIENT APRDRG 8151: OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES

Facility IP

$5,430.27

Service Code	APR-DRG 8151
Hospital Charge Code	APRDRG 8151
Min. Negotiated Rate	$1,967.07
Max. Negotiated Rate	$5,430.27
Rate for Payer: Buckeye Health Medicaid OOS	$1,967.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$5,430.27
Rate for Payer: Managed Health Services Medicaid	$5,430.27
Rate for Payer: MDWise Medicaid	$5,430.27
Rate for Payer: Molina Healthcare of OH Medicare	$1,967.07

INPATIENT APRDRG 8152: OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES

Facility IP

$7,639.14

Service Code	APR-DRG 8152
Hospital Charge Code	APRDRG 8152
Min. Negotiated Rate	$2,481.98
Max. Negotiated Rate	$7,639.14
Rate for Payer: Buckeye Health Medicaid OOS	$2,481.98
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$7,639.14
Rate for Payer: Managed Health Services Medicaid	$7,639.14
Rate for Payer: MDWise Medicaid	$7,639.14
Rate for Payer: Molina Healthcare of OH Medicare	$2,481.98

INPATIENT APRDRG 8153: OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES

Facility IP

$9,591.47

Service Code	APR-DRG 8153
Hospital Charge Code	APRDRG 8153
Min. Negotiated Rate	$3,869.15
Max. Negotiated Rate	$9,591.47
Rate for Payer: Buckeye Health Medicaid OOS	$3,869.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,591.47
Rate for Payer: Managed Health Services Medicaid	$9,591.47
Rate for Payer: MDWise Medicaid	$9,591.47
Rate for Payer: Molina Healthcare of OH Medicare	$3,869.15

INPATIENT APRDRG 8154: OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES

Facility IP

$23,643.83

Service Code	APR-DRG 8154
Hospital Charge Code	APRDRG 8154
Min. Negotiated Rate	$11,443.81
Max. Negotiated Rate	$23,643.83
Rate for Payer: Buckeye Health Medicaid OOS	$11,443.81
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,643.83
Rate for Payer: Managed Health Services Medicaid	$23,643.83
Rate for Payer: MDWise Medicaid	$23,643.83
Rate for Payer: Molina Healthcare of OH Medicare	$11,443.81

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