Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

PR OTI OPN LITHIUM BATTERY

Professional

$50.00

Service Code	CPT V5266
Hospital Charge Code	zV5266D
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$50.00
Rate for Payer: Cash Price	$31.00
Rate for Payer: PHCS All Commercial	$37.50
Rate for Payer: Signature Care EPO	$50.00
Rate for Payer: Signature Care PPO	$50.00

PR OTI OPN MINIR RECHG 1 BAT

Professional

$50.00

Service Code	CPT V5266
Hospital Charge Code	zV5266C
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$50.00
Rate for Payer: Cash Price	$31.00
Rate for Payer: PHCS All Commercial	$37.50
Rate for Payer: Signature Care EPO	$50.00
Rate for Payer: Signature Care PPO	$50.00

PR OTI OPN MINIR ZPOWERRCHRGBL

Professional

$500.00

Service Code	CPT V5267
Hospital Charge Code	zV5267N
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$500.00
Rate for Payer: Cash Price	$310.00
Rate for Payer: PHCS All Commercial	$375.00
Rate for Payer: Signature Care EPO	$500.00
Rate for Payer: Signature Care PPO	$500.00

PR OTI OPN MINIR ZPOWERRCHRGBL

Professional

$500.00

Service Code	CPT V5267
Hospital Charge Code	zV5267K
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$500.00
Rate for Payer: Cash Price	$310.00
Rate for Payer: PHCS All Commercial	$375.00
Rate for Payer: Signature Care EPO	$500.00
Rate for Payer: Signature Care PPO	$500.00

PR OTI OPN PLAY 1 BTE PP HA BI

Professional

$5,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AI
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: PHCS All Commercial	$3,750.00
Rate for Payer: Signature Care EPO	$5,000.00
Rate for Payer: Signature Care PPO	$5,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTI OPN PLAY 1 BTE PP HA MON

Professional

$2,500.00

Service Code	CPT V5257
Hospital Charge Code	zV5257AR
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: PHCS All Commercial	$1,875.00
Rate for Payer: Signature Care EPO	$2,500.00
Rate for Payer: Signature Care PPO	$2,500.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTI OPN PLAY 1 MINIR BTE HA BI

Professional

$5,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AG
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: PHCS All Commercial	$3,750.00
Rate for Payer: Signature Care EPO	$5,000.00
Rate for Payer: Signature Care PPO	$5,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTI OPN PLAY1 MINIR BTE HA MON

Professional

$2,500.00

Service Code	CPT V5257
Hospital Charge Code	zV5257AP
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: PHCS All Commercial	$1,875.00
Rate for Payer: Signature Care EPO	$2,500.00
Rate for Payer: Signature Care PPO	$2,500.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTIOPNPLAY1 MINIR R BTE HA BI

Professional

$5,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AK
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: PHCS All Commercial	$3,750.00
Rate for Payer: Signature Care EPO	$5,000.00
Rate for Payer: Signature Care PPO	$5,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTIOPNPLAY1 MINIR R BTE HA MON

Professional

$2,500.00

Service Code	CPT V5257
Hospital Charge Code	zV5257AX
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: PHCS All Commercial	$1,875.00
Rate for Payer: Signature Care EPO	$2,500.00
Rate for Payer: Signature Care PPO	$2,500.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTI OPNPLAY1 MINIR T BTE HA BI

Professional

$5,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AH
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: PHCS All Commercial	$3,750.00
Rate for Payer: Signature Care EPO	$5,000.00
Rate for Payer: Signature Care PPO	$5,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTIOPNPLAY1 MINIR T BTE HA MON

Professional

$2,500.00

Service Code	CPT V5257
Hospital Charge Code	zV5257AQ
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: PHCS All Commercial	$1,875.00
Rate for Payer: Signature Care EPO	$2,500.00
Rate for Payer: Signature Care PPO	$2,500.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTI OPN PLAY 2 BTE PP HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AN
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTI OPN PLAY 2 BTE PP HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257BB
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTI OPN PLAY 2 MINIR BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AL
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTI OPN PLAY2 MINIR BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257AZ
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTIOPNPLAY2 MINIR R BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AP
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTIOPNPLAY2 MINIR R BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257BH
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTI OPNPLAY2 MINIR T BTE HA BI

Professional

$2,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261AM
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: Cash Price	$1,240.00
Rate for Payer: PHCS All Commercial	$1,500.00
Rate for Payer: Signature Care EPO	$2,000.00
Rate for Payer: Signature Care PPO	$2,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTIOPNPLAY2 MINIR T BTE HA MON

Professional

$1,000.00

Service Code	CPT V5257
Hospital Charge Code	zV5257BA
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: PHCS All Commercial	$750.00
Rate for Payer: Signature Care EPO	$1,000.00
Rate for Payer: Signature Care PPO	$1,000.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTI OPN REMOTE CONTROL 3.0

Professional

$300.00

Service Code	CPT V5270
Hospital Charge Code	zV5270C
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$300.00
Rate for Payer: Cash Price	$186.00
Rate for Payer: PHCS All Commercial	$225.00
Rate for Payer: Signature Care EPO	$300.00
Rate for Payer: Signature Care PPO	$300.00

PR OTI OPN S1 HA BTE BI

Professional

$5,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261BK
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: Cash Price	$3,100.00
Rate for Payer: PHCS All Commercial	$3,750.00
Rate for Payer: Signature Care EPO	$5,000.00
Rate for Payer: Signature Care PPO	$5,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTI OPN S1 HA BTE MONO

Professional

$2,500.00

Service Code	CPT V5257
Hospital Charge Code	zV5257CX
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: Cash Price	$1,550.00
Rate for Payer: PHCS All Commercial	$1,875.00
Rate for Payer: Signature Care EPO	$2,500.00
Rate for Payer: Signature Care PPO	$2,500.00
Rate for Payer: United Healthcare Commercial	$2,500.00

PR OTI OPN S2 HA BTE BI

Professional

$3,000.00

Service Code	CPT V5261
Hospital Charge Code	zV5261BL
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Cash Price	$1,860.00
Rate for Payer: Cash Price	$1,860.00
Rate for Payer: PHCS All Commercial	$2,250.00
Rate for Payer: Signature Care EPO	$3,000.00
Rate for Payer: Signature Care PPO	$3,000.00
Rate for Payer: United Healthcare Commercial	$5,000.00

PR OTI OPN S2 HA BTE MONO

Professional

$1,500.00

Service Code	CPT V5257
Hospital Charge Code	zV5257CY
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Cash Price	$930.00
Rate for Payer: Cash Price	$930.00
Rate for Payer: PHCS All Commercial	$1,125.00
Rate for Payer: Signature Care EPO	$1,500.00
Rate for Payer: Signature Care PPO	$1,500.00
Rate for Payer: United Healthcare Commercial	$2,500.00

Price Transparency.

All Charges