Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 8923: HIV W MAJOR HIV RELATED CONDITION

Facility IP

$11,997.66

Service Code	APR-DRG 8923
Hospital Charge Code	APRDRG 8923
Min. Negotiated Rate	$3,604.33
Max. Negotiated Rate	$11,997.66
Rate for Payer: Buckeye Health Medicaid OOS	$3,604.33
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$11,997.66
Rate for Payer: Managed Health Services Medicaid	$11,997.66
Rate for Payer: MDWise Medicaid	$11,997.66
Rate for Payer: Molina Healthcare of OH Medicare	$3,604.33

INPATIENT APRDRG 8924: HIV W MAJOR HIV RELATED CONDITION

Facility IP

$25,698.53

Service Code	APR-DRG 8924
Hospital Charge Code	APRDRG 8924
Min. Negotiated Rate	$5,453.88
Max. Negotiated Rate	$25,698.53
Rate for Payer: Buckeye Health Medicaid OOS	$5,453.88
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$25,698.53
Rate for Payer: Managed Health Services Medicaid	$25,698.53
Rate for Payer: MDWise Medicaid	$25,698.53
Rate for Payer: Molina Healthcare of OH Medicare	$5,453.88

INPATIENT APRDRG 8931: HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility IP

$9,022.91

Service Code	APR-DRG 8931
Hospital Charge Code	APRDRG 8931
Min. Negotiated Rate	$2,439.07
Max. Negotiated Rate	$9,022.91
Rate for Payer: Buckeye Health Medicaid OOS	$2,439.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,022.91
Rate for Payer: Managed Health Services Medicaid	$9,022.91
Rate for Payer: MDWise Medicaid	$9,022.91
Rate for Payer: Molina Healthcare of OH Medicare	$2,439.07

INPATIENT APRDRG 8932: HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility IP

$9,022.91

Service Code	APR-DRG 8932
Hospital Charge Code	APRDRG 8932
Min. Negotiated Rate	$2,439.07
Max. Negotiated Rate	$9,022.91
Rate for Payer: Buckeye Health Medicaid OOS	$2,439.07
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,022.91
Rate for Payer: Managed Health Services Medicaid	$9,022.91
Rate for Payer: MDWise Medicaid	$9,022.91
Rate for Payer: Molina Healthcare of OH Medicare	$2,439.07

INPATIENT APRDRG 8933: HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility IP

$9,022.91

Service Code	APR-DRG 8933
Hospital Charge Code	APRDRG 8933
Min. Negotiated Rate	$3,793.90
Max. Negotiated Rate	$9,022.91
Rate for Payer: Buckeye Health Medicaid OOS	$3,793.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,022.91
Rate for Payer: Managed Health Services Medicaid	$9,022.91
Rate for Payer: MDWise Medicaid	$9,022.91
Rate for Payer: Molina Healthcare of OH Medicare	$3,793.90

INPATIENT APRDRG 8934: HIV W MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility IP

$14,944.05

Service Code	APR-DRG 8934
Hospital Charge Code	APRDRG 8934
Min. Negotiated Rate	$3,793.90
Max. Negotiated Rate	$14,944.05
Rate for Payer: Buckeye Health Medicaid OOS	$3,793.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,944.05
Rate for Payer: Managed Health Services Medicaid	$14,944.05
Rate for Payer: MDWise Medicaid	$14,944.05
Rate for Payer: Molina Healthcare of OH Medicare	$3,793.90

INPATIENT APRDRG 8941: HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND

Facility IP

$9,608.74

Service Code	APR-DRG 8941
Hospital Charge Code	APRDRG 8941
Min. Negotiated Rate	$2,032.72
Max. Negotiated Rate	$9,608.74
Rate for Payer: Buckeye Health Medicaid OOS	$2,032.72
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,608.74
Rate for Payer: Managed Health Services Medicaid	$9,608.74
Rate for Payer: MDWise Medicaid	$9,608.74
Rate for Payer: Molina Healthcare of OH Medicare	$2,032.72

INPATIENT APRDRG 8942: HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND

Facility IP

$9,608.74

Service Code	APR-DRG 8942
Hospital Charge Code	APRDRG 8942
Min. Negotiated Rate	$2,110.21
Max. Negotiated Rate	$9,608.74
Rate for Payer: Buckeye Health Medicaid OOS	$2,110.21
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,608.74
Rate for Payer: Managed Health Services Medicaid	$9,608.74
Rate for Payer: MDWise Medicaid	$9,608.74
Rate for Payer: Molina Healthcare of OH Medicare	$2,110.21

INPATIENT APRDRG 8943: HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND

Facility IP

$9,608.74

Service Code	APR-DRG 8943
Hospital Charge Code	APRDRG 8943
Min. Negotiated Rate	$3,574.87
Max. Negotiated Rate	$9,608.74
Rate for Payer: Buckeye Health Medicaid OOS	$3,574.87
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,608.74
Rate for Payer: Managed Health Services Medicaid	$9,608.74
Rate for Payer: MDWise Medicaid	$9,608.74
Rate for Payer: Molina Healthcare of OH Medicare	$3,574.87

INPATIENT APRDRG 8944: HIV W ONE SIGNIF HIV COND OR W/O SIGNIF RELATED COND

Facility IP

$14,080.73

Service Code	APR-DRG 8944
Hospital Charge Code	APRDRG 8944
Min. Negotiated Rate	$3,574.87
Max. Negotiated Rate	$14,080.73
Rate for Payer: Buckeye Health Medicaid OOS	$3,574.87
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$14,080.73
Rate for Payer: Managed Health Services Medicaid	$14,080.73
Rate for Payer: MDWise Medicaid	$14,080.73
Rate for Payer: Molina Healthcare of OH Medicare	$3,574.87

INPATIENT APRDRG 9101: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA

Facility IP

$52,002.62

Service Code	APR-DRG 9101
Hospital Charge Code	APRDRG 9101
Min. Negotiated Rate	$13,766.96
Max. Negotiated Rate	$52,002.62
Rate for Payer: Buckeye Health Medicaid OOS	$13,766.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$52,002.62
Rate for Payer: Managed Health Services Medicaid	$52,002.62
Rate for Payer: MDWise Medicaid	$52,002.62
Rate for Payer: Molina Healthcare of OH Medicare	$13,766.96

INPATIENT APRDRG 9102: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA

Facility IP

$52,002.62

Service Code	APR-DRG 9102
Hospital Charge Code	APRDRG 9102
Min. Negotiated Rate	$13,766.96
Max. Negotiated Rate	$52,002.62
Rate for Payer: Buckeye Health Medicaid OOS	$13,766.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$52,002.62
Rate for Payer: Managed Health Services Medicaid	$52,002.62
Rate for Payer: MDWise Medicaid	$52,002.62
Rate for Payer: Molina Healthcare of OH Medicare	$13,766.96

INPATIENT APRDRG 9103: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA

Facility IP

$52,002.62

Service Code	APR-DRG 9103
Hospital Charge Code	APRDRG 9103
Min. Negotiated Rate	$13,766.96
Max. Negotiated Rate	$52,002.62
Rate for Payer: Buckeye Health Medicaid OOS	$13,766.96
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$52,002.62
Rate for Payer: Managed Health Services Medicaid	$52,002.62
Rate for Payer: MDWise Medicaid	$52,002.62
Rate for Payer: Molina Healthcare of OH Medicare	$13,766.96

INPATIENT APRDRG 9104: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA

Facility IP

$80,534.07

Service Code	APR-DRG 9104
Hospital Charge Code	APRDRG 9104
Min. Negotiated Rate	$23,490.26
Max. Negotiated Rate	$80,534.07
Rate for Payer: Buckeye Health Medicaid OOS	$23,490.26
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$80,534.07
Rate for Payer: Managed Health Services Medicaid	$80,534.07
Rate for Payer: MDWise Medicaid	$80,534.07
Rate for Payer: Molina Healthcare of OH Medicare	$23,490.26

INPATIENT APRDRG 9111: EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA

Facility IP

$23,844.86

Service Code	APR-DRG 9111
Hospital Charge Code	APRDRG 9111
Min. Negotiated Rate	$6,053.65
Max. Negotiated Rate	$23,844.86
Rate for Payer: Buckeye Health Medicaid OOS	$6,053.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,844.86
Rate for Payer: Managed Health Services Medicaid	$23,844.86
Rate for Payer: MDWise Medicaid	$23,844.86
Rate for Payer: Molina Healthcare of OH Medicare	$6,053.65

INPATIENT APRDRG 9112: EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA

Facility IP

$24,375.19

Service Code	APR-DRG 9112
Hospital Charge Code	APRDRG 9112
Min. Negotiated Rate	$6,053.65
Max. Negotiated Rate	$24,375.19
Rate for Payer: Buckeye Health Medicaid OOS	$6,053.65
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$24,375.19
Rate for Payer: Managed Health Services Medicaid	$24,375.19
Rate for Payer: MDWise Medicaid	$24,375.19
Rate for Payer: Molina Healthcare of OH Medicare	$6,053.65

INPATIENT APRDRG 9113: EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA

Facility IP

$36,052.19

Service Code	APR-DRG 9113
Hospital Charge Code	APRDRG 9113
Min. Negotiated Rate	$8,278.17
Max. Negotiated Rate	$36,052.19
Rate for Payer: Buckeye Health Medicaid OOS	$8,278.17
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$36,052.19
Rate for Payer: Managed Health Services Medicaid	$36,052.19
Rate for Payer: MDWise Medicaid	$36,052.19
Rate for Payer: Molina Healthcare of OH Medicare	$8,278.17

INPATIENT APRDRG 9114: EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT TRAUMA

Facility IP

$72,184.55

Service Code	APR-DRG 9114
Hospital Charge Code	APRDRG 9114
Min. Negotiated Rate	$20,040.91
Max. Negotiated Rate	$72,184.55
Rate for Payer: Buckeye Health Medicaid OOS	$20,040.91
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$72,184.55
Rate for Payer: Managed Health Services Medicaid	$72,184.55
Rate for Payer: MDWise Medicaid	$72,184.55
Rate for Payer: Molina Healthcare of OH Medicare	$20,040.91

INPATIENT APRDRG 9121: MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility IP

$27,150.14

Service Code	APR-DRG 9121
Hospital Charge Code	APRDRG 9121
Min. Negotiated Rate	$6,892.93
Max. Negotiated Rate	$27,150.14
Rate for Payer: Buckeye Health Medicaid OOS	$6,892.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$27,150.14
Rate for Payer: Managed Health Services Medicaid	$27,150.14
Rate for Payer: MDWise Medicaid	$27,150.14
Rate for Payer: Molina Healthcare of OH Medicare	$6,892.93

INPATIENT APRDRG 9122: MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility IP

$31,107.84

Service Code	APR-DRG 9122
Hospital Charge Code	APRDRG 9122
Min. Negotiated Rate	$6,892.93
Max. Negotiated Rate	$31,107.84
Rate for Payer: Buckeye Health Medicaid OOS	$6,892.93
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$31,107.84
Rate for Payer: Managed Health Services Medicaid	$31,107.84
Rate for Payer: MDWise Medicaid	$31,107.84
Rate for Payer: Molina Healthcare of OH Medicare	$6,892.93

INPATIENT APRDRG 9123: MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility IP

$52,457.71

Service Code	APR-DRG 9123
Hospital Charge Code	APRDRG 9123
Min. Negotiated Rate	$10,619.90
Max. Negotiated Rate	$52,457.71
Rate for Payer: Buckeye Health Medicaid OOS	$10,619.90
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$52,457.71
Rate for Payer: Managed Health Services Medicaid	$52,457.71
Rate for Payer: MDWise Medicaid	$52,457.71
Rate for Payer: Molina Healthcare of OH Medicare	$10,619.90

INPATIENT APRDRG 9124: MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility IP

$83,006.86

Service Code	APR-DRG 9124
Hospital Charge Code	APRDRG 9124
Min. Negotiated Rate	$21,002.20
Max. Negotiated Rate	$83,006.86
Rate for Payer: Buckeye Health Medicaid OOS	$21,002.20
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$83,006.86
Rate for Payer: Managed Health Services Medicaid	$83,006.86
Rate for Payer: MDWise Medicaid	$83,006.86
Rate for Payer: Molina Healthcare of OH Medicare	$21,002.20

INPATIENT APRDRG 9301: MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE

Facility IP

$9,798.67

Service Code	APR-DRG 9301
Hospital Charge Code	APRDRG 9301
Min. Negotiated Rate	$2,525.53
Max. Negotiated Rate	$9,798.67
Rate for Payer: Buckeye Health Medicaid OOS	$2,525.53
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$9,798.67
Rate for Payer: Managed Health Services Medicaid	$9,798.67
Rate for Payer: MDWise Medicaid	$9,798.67
Rate for Payer: Molina Healthcare of OH Medicare	$2,525.53

INPATIENT APRDRG 9302: MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE

Facility IP

$13,868.60

Service Code	APR-DRG 9302
Hospital Charge Code	APRDRG 9302
Min. Negotiated Rate	$2,525.53
Max. Negotiated Rate	$13,868.60
Rate for Payer: Buckeye Health Medicaid OOS	$2,525.53
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$13,868.60
Rate for Payer: Managed Health Services Medicaid	$13,868.60
Rate for Payer: MDWise Medicaid	$13,868.60
Rate for Payer: Molina Healthcare of OH Medicare	$2,525.53

INPATIENT APRDRG 9303: MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE

Facility IP

$17,910.16

Service Code	APR-DRG 9303
Hospital Charge Code	APRDRG 9303
Min. Negotiated Rate	$4,488.44
Max. Negotiated Rate	$17,910.16
Rate for Payer: Buckeye Health Medicaid OOS	$4,488.44
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$17,910.16
Rate for Payer: Managed Health Services Medicaid	$17,910.16
Rate for Payer: MDWise Medicaid	$17,910.16
Rate for Payer: Molina Healthcare of OH Medicare	$4,488.44

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