Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

INPATIENT APRDRG 9304: MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE

Facility IP

$30,438.15

Service Code	APR-DRG 9304
Hospital Charge Code	APRDRG 9304
Min. Negotiated Rate	$14,284.43
Max. Negotiated Rate	$30,438.15
Rate for Payer: Buckeye Health Medicaid OOS	$14,284.43
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$30,438.15
Rate for Payer: Managed Health Services Medicaid	$30,438.15
Rate for Payer: MDWise Medicaid	$30,438.15
Rate for Payer: Molina Healthcare of OH Medicare	$14,284.43

INPATIENT APRDRG 9501: EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$19,270.51

Service Code	APR-DRG 9501
Hospital Charge Code	APRDRG 9501
Min. Negotiated Rate	$4,400.06
Max. Negotiated Rate	$19,270.51
Rate for Payer: Buckeye Health Medicaid OOS	$4,400.06
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$19,270.51
Rate for Payer: Managed Health Services Medicaid	$19,270.51
Rate for Payer: MDWise Medicaid	$19,270.51
Rate for Payer: Molina Healthcare of OH Medicare	$4,400.06

INPATIENT APRDRG 9502: EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$28,266.29

Service Code	APR-DRG 9502
Hospital Charge Code	APRDRG 9502
Min. Negotiated Rate	$5,819.25
Max. Negotiated Rate	$28,266.29
Rate for Payer: Buckeye Health Medicaid OOS	$5,819.25
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$28,266.29
Rate for Payer: Managed Health Services Medicaid	$28,266.29
Rate for Payer: MDWise Medicaid	$28,266.29
Rate for Payer: Molina Healthcare of OH Medicare	$5,819.25

INPATIENT APRDRG 9503: EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$29,803.00

Service Code	APR-DRG 9503
Hospital Charge Code	APRDRG 9503
Min. Negotiated Rate	$6,926.55
Max. Negotiated Rate	$29,803.00
Rate for Payer: Buckeye Health Medicaid OOS	$6,926.55
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$29,803.00
Rate for Payer: Managed Health Services Medicaid	$29,803.00
Rate for Payer: MDWise Medicaid	$29,803.00
Rate for Payer: Molina Healthcare of OH Medicare	$6,926.55

INPATIENT APRDRG 9504: EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$65,160.83

Service Code	APR-DRG 9504
Hospital Charge Code	APRDRG 9504
Min. Negotiated Rate	$15,962.99
Max. Negotiated Rate	$65,160.83
Rate for Payer: Buckeye Health Medicaid OOS	$15,962.99
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$65,160.83
Rate for Payer: Managed Health Services Medicaid	$65,160.83
Rate for Payer: MDWise Medicaid	$65,160.83
Rate for Payer: Molina Healthcare of OH Medicare	$15,962.99

INPATIENT APRDRG 9511: MODERATELY EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$15,598.94

Service Code	APR-DRG 9511
Hospital Charge Code	APRDRG 9511
Min. Negotiated Rate	$3,340.15
Max. Negotiated Rate	$15,598.94
Rate for Payer: Buckeye Health Medicaid OOS	$3,340.15
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,598.94
Rate for Payer: Managed Health Services Medicaid	$15,598.94
Rate for Payer: MDWise Medicaid	$15,598.94
Rate for Payer: Molina Healthcare of OH Medicare	$3,340.15

INPATIENT APRDRG 9512: MODERATELY EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$20,792.42

Service Code	APR-DRG 9512
Hospital Charge Code	APRDRG 9512
Min. Negotiated Rate	$4,654.63
Max. Negotiated Rate	$20,792.42
Rate for Payer: Buckeye Health Medicaid OOS	$4,654.63
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$20,792.42
Rate for Payer: Managed Health Services Medicaid	$20,792.42
Rate for Payer: MDWise Medicaid	$20,792.42
Rate for Payer: Molina Healthcare of OH Medicare	$4,654.63

INPATIENT APRDRG 9513: MODERATELY EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$34,089.99

Service Code	APR-DRG 9513
Hospital Charge Code	APRDRG 9513
Min. Negotiated Rate	$7,323.29
Max. Negotiated Rate	$34,089.99
Rate for Payer: Buckeye Health Medicaid OOS	$7,323.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$34,089.99
Rate for Payer: Managed Health Services Medicaid	$34,089.99
Rate for Payer: MDWise Medicaid	$34,089.99
Rate for Payer: Molina Healthcare of OH Medicare	$7,323.29

INPATIENT APRDRG 9514: MODERATELY EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$52,574.88

Service Code	APR-DRG 9514
Hospital Charge Code	APRDRG 9514
Min. Negotiated Rate	$15,552.79
Max. Negotiated Rate	$52,574.88
Rate for Payer: Buckeye Health Medicaid OOS	$15,552.79
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$52,574.88
Rate for Payer: Managed Health Services Medicaid	$52,574.88
Rate for Payer: MDWise Medicaid	$52,574.88
Rate for Payer: Molina Healthcare of OH Medicare	$15,552.79

INPATIENT APRDRG 9521: NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$10,576.89

Service Code	APR-DRG 9521
Hospital Charge Code	APRDRG 9521
Min. Negotiated Rate	$3,181.01
Max. Negotiated Rate	$10,576.89
Rate for Payer: Buckeye Health Medicaid OOS	$3,181.01
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$10,576.89
Rate for Payer: Managed Health Services Medicaid	$10,576.89
Rate for Payer: MDWise Medicaid	$10,576.89
Rate for Payer: Molina Healthcare of OH Medicare	$3,181.01

INPATIENT APRDRG 9522: NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$15,708.70

Service Code	APR-DRG 9522
Hospital Charge Code	APRDRG 9522
Min. Negotiated Rate	$4,028.29
Max. Negotiated Rate	$15,708.70
Rate for Payer: Buckeye Health Medicaid OOS	$4,028.29
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$15,708.70
Rate for Payer: Managed Health Services Medicaid	$15,708.70
Rate for Payer: MDWise Medicaid	$15,708.70
Rate for Payer: Molina Healthcare of OH Medicare	$4,028.29

INPATIENT APRDRG 9523: NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$23,409.50

Service Code	APR-DRG 9523
Hospital Charge Code	APRDRG 9523
Min. Negotiated Rate	$6,777.33
Max. Negotiated Rate	$23,409.50
Rate for Payer: Buckeye Health Medicaid OOS	$6,777.33
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$23,409.50
Rate for Payer: Managed Health Services Medicaid	$23,409.50
Rate for Payer: MDWise Medicaid	$23,409.50
Rate for Payer: Molina Healthcare of OH Medicare	$6,777.33

INPATIENT APRDRG 9524: NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility IP

$38,083.46

Service Code	APR-DRG 9524
Hospital Charge Code	APRDRG 9524
Min. Negotiated Rate	$13,041.04
Max. Negotiated Rate	$38,083.46
Rate for Payer: Buckeye Health Medicaid OOS	$13,041.04
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise	$38,083.46
Rate for Payer: Managed Health Services Medicaid	$38,083.46
Rate for Payer: MDWise Medicaid	$38,083.46
Rate for Payer: Molina Healthcare of OH Medicare	$13,041.04

INPATIENT MSDRG 001: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC

Facility IP

$276,197.68

Service Code	MS-DRG 001
Hospital Charge Code	MSDRG 001
Min. Negotiated Rate	$158,394.43
Max. Negotiated Rate	$276,197.68
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$234,147.41
Rate for Payer: Anthem Blue Cross of IN Traditional	$276,197.68
Rate for Payer: Plain Church Group Ministry All Commercial	$158,394.43
Rate for Payer: Three Rivers Preferred All Commercial	$206,873.84

INPATIENT MSDRG 002: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC

Facility IP

$132,211.53

Service Code	MS-DRG 002
Hospital Charge Code	MSDRG 002
Min. Negotiated Rate	$75,820.95
Max. Negotiated Rate	$132,211.53
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$112,082.72
Rate for Payer: Anthem Blue Cross of IN Traditional	$132,211.53
Rate for Payer: Plain Church Group Ministry All Commercial	$75,820.95
Rate for Payer: Three Rivers Preferred All Commercial	$99,027.29

INPATIENT MSDRG 003: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES

Facility IP

$198,586.66

Service Code	MS-DRG 003
Hospital Charge Code	MSDRG 003
Min. Negotiated Rate	$113,885.90
Max. Negotiated Rate	$198,586.66
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$168,352.43
Rate for Payer: Anthem Blue Cross of IN Traditional	$198,586.66
Rate for Payer: Plain Church Group Ministry All Commercial	$113,885.90
Rate for Payer: Three Rivers Preferred All Commercial	$148,742.69

INPATIENT MSDRG 004: TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES

Facility IP

$134,749.17

Service Code	MS-DRG 004
Hospital Charge Code	MSDRG 004
Min. Negotiated Rate	$77,276.24
Max. Negotiated Rate	$134,749.17
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$114,234.01
Rate for Payer: Anthem Blue Cross of IN Traditional	$134,749.17
Rate for Payer: Plain Church Group Ministry All Commercial	$77,276.24
Rate for Payer: Three Rivers Preferred All Commercial	$100,928.00

INPATIENT MSDRG 005: LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT

Facility IP

$111,936.89

Service Code	MS-DRG 005
Hospital Charge Code	MSDRG 005
Min. Negotiated Rate	$64,193.81
Max. Negotiated Rate	$111,936.89
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$94,894.83
Rate for Payer: Anthem Blue Cross of IN Traditional	$111,936.89
Rate for Payer: Plain Church Group Ministry All Commercial	$64,193.81
Rate for Payer: Three Rivers Preferred All Commercial	$83,841.45

INPATIENT MSDRG 006: LIVER TRANSPLANT WITHOUT MCC

Facility IP

$47,193.66

Service Code	MS-DRG 006
Hospital Charge Code	MSDRG 006
Min. Negotiated Rate	$27,064.72
Max. Negotiated Rate	$47,193.66
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$40,008.57
Rate for Payer: Anthem Blue Cross of IN Traditional	$47,193.66
Rate for Payer: Plain Church Group Ministry All Commercial	$27,064.72
Rate for Payer: Three Rivers Preferred All Commercial	$35,348.36

INPATIENT MSDRG 007: LUNG TRANSPLANT

Facility IP

$119,790.23

Service Code	MS-DRG 007
Hospital Charge Code	MSDRG 007
Min. Negotiated Rate	$68,697.56
Max. Negotiated Rate	$119,790.23
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$101,552.53
Rate for Payer: Anthem Blue Cross of IN Traditional	$119,790.23
Rate for Payer: Plain Church Group Ministry All Commercial	$68,697.56
Rate for Payer: Three Rivers Preferred All Commercial	$89,723.66

INPATIENT MSDRG 008: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT

Facility IP

$54,865.46

Service Code	MS-DRG 008
Hospital Charge Code	MSDRG 008
Min. Negotiated Rate	$31,464.36
Max. Negotiated Rate	$54,865.46
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$46,512.36
Rate for Payer: Anthem Blue Cross of IN Traditional	$54,865.46
Rate for Payer: Plain Church Group Ministry All Commercial	$31,464.36
Rate for Payer: Three Rivers Preferred All Commercial	$41,094.59

INPATIENT MSDRG 010: PANCREAS TRANSPLANT

Facility IP

$40,692.55

Service Code	MS-DRG 010
Hospital Charge Code	MSDRG 010
Min. Negotiated Rate	$23,336.45
Max. Negotiated Rate	$40,692.55
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$34,497.23
Rate for Payer: Anthem Blue Cross of IN Traditional	$40,692.55
Rate for Payer: Plain Church Group Ministry All Commercial	$23,336.45
Rate for Payer: Three Rivers Preferred All Commercial	$30,478.98

INPATIENT MSDRG 011: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC

Facility IP

$50,686.11

Service Code	MS-DRG 011
Hospital Charge Code	MSDRG 011
Min. Negotiated Rate	$29,067.58
Max. Negotiated Rate	$50,686.11
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$42,969.30
Rate for Payer: Anthem Blue Cross of IN Traditional	$50,686.11
Rate for Payer: Plain Church Group Ministry All Commercial	$29,067.58
Rate for Payer: Three Rivers Preferred All Commercial	$37,964.22

INPATIENT MSDRG 012: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC

Facility IP

$38,363.92

Service Code	MS-DRG 012
Hospital Charge Code	MSDRG 012
Min. Negotiated Rate	$22,001.02
Max. Negotiated Rate	$38,363.92
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$32,523.13
Rate for Payer: Anthem Blue Cross of IN Traditional	$38,363.92
Rate for Payer: Plain Church Group Ministry All Commercial	$22,001.02
Rate for Payer: Three Rivers Preferred All Commercial	$28,734.83

INPATIENT MSDRG 013: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC

Facility IP

$27,754.11

Service Code	MS-DRG 013
Hospital Charge Code	MSDRG 013
Min. Negotiated Rate	$15,916.48
Max. Negotiated Rate	$27,754.11
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange	$23,528.63
Rate for Payer: Anthem Blue Cross of IN Traditional	$27,754.11
Rate for Payer: Plain Church Group Ministry All Commercial	$15,916.48
Rate for Payer: Three Rivers Preferred All Commercial	$20,788.01

Price Transparency.

All Charges