Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: CLASS VII PHARMACOTHERAPY

Facility

$588.31

Service Code	EAPG 00444
Min. Negotiated Rate	$588.31
Max. Negotiated Rate	$588.31
Rate for Payer: Buckeye Health Medicaid OOS	$588.31
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$588.31

EAPG 3.18: CLASS VI PHARMACOTHERAPY

Facility

$392.82

Service Code	EAPG 00440
Min. Negotiated Rate	$392.82
Max. Negotiated Rate	$392.82
Rate for Payer: Buckeye Health Medicaid OOS	$392.82
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$392.82

EAPG 3.18: CLASS V PHARMACOTHERAPY

Facility

$252.40

Service Code	EAPG 00439
Min. Negotiated Rate	$252.40
Max. Negotiated Rate	$252.40
Rate for Payer: Buckeye Health Medicaid OOS	$252.40
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$252.40

EAPG 3.18: CLASS X COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY

Facility

$1,853.96

Service Code	EAPG 00462
Min. Negotiated Rate	$1,853.96
Max. Negotiated Rate	$1,853.96
Rate for Payer: Buckeye Health Medicaid OOS	$1,853.96
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,853.96

EAPG 3.18: CLASS XI COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY

Facility

$2,990.19

Service Code	EAPG 00463
Min. Negotiated Rate	$2,990.19
Max. Negotiated Rate	$2,990.19
Rate for Payer: Buckeye Health Medicaid OOS	$2,990.19
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$2,990.19

EAPG 3.18: CLASS XII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY

Facility

$4,589.92

Service Code	EAPG 00464
Min. Negotiated Rate	$4,589.92
Max. Negotiated Rate	$4,589.92
Rate for Payer: Buckeye Health Medicaid OOS	$4,589.92
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$4,589.92

EAPG 3.18: CLEFT LIP AND PALATE REPAIR

Facility

$1,537.32

Service Code	EAPG 00262
Min. Negotiated Rate	$1,537.32
Max. Negotiated Rate	$1,537.32
Rate for Payer: Buckeye Health Medicaid OOS	$1,537.32
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,537.32

EAPG 3.18: CLOSED TREATMENT FX AND DISLOCATION

Facility

$251.48

Service Code	EAPG 00041
Min. Negotiated Rate	$251.48
Max. Negotiated Rate	$251.48
Rate for Payer: Buckeye Health Medicaid OOS	$251.48
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$251.48

EAPG 3.18: COAGULATION AND PLATELET DISORDERS AND CONGENITAL FACTOR DEFICIENCIES

Facility

$62.41

Service Code	EAPG 00781
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$62.41
Rate for Payer: Buckeye Health Medicaid OOS	$62.41
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$62.41

EAPG 3.18: COCAINE ABUSE AND DEPENDENCE

Facility

$73.42

Service Code	EAPG 00841
Min. Negotiated Rate	$73.42
Max. Negotiated Rate	$73.42
Rate for Payer: Buckeye Health Medicaid OOS	$73.42
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$73.42

EAPG 3.18: COCHLEAR DEVICE IMPLANTATION

Facility

$15,459.42

Service Code	EAPG 00250
Min. Negotiated Rate	$15,459.42
Max. Negotiated Rate	$15,459.42
Rate for Payer: Buckeye Health Medicaid OOS	$15,459.42
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$15,459.42

EAPG 3.18: COMPLEX BLOOD COLLECTION SERVICES

Facility

$15.60

Service Code	EAPG 00494
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Buckeye Health Medicaid OOS	$15.60
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$15.60

EAPG 3.18: COMPLEX KIDNEY AND URINARY TRACT INFECTIONS

Facility

$73.42

Service Code	EAPG 00723
Min. Negotiated Rate	$73.42
Max. Negotiated Rate	$73.42
Rate for Payer: Buckeye Health Medicaid OOS	$73.42
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$73.42

EAPG 3.18: COMPLEX WOUND REPAIR AND TREATMENT

Facility

$695.69

Service Code	EAPG 00018
Min. Negotiated Rate	$695.69
Max. Negotiated Rate	$695.69
Rate for Payer: Buckeye Health Medicaid OOS	$695.69
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$695.69

EAPG 3.18: COMPLICATIONS OF TREATMENT AFFECTING PREGNANCY

Facility

$69.75

Service Code	EAPG 00767
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$69.75
Rate for Payer: Buckeye Health Medicaid OOS	$69.75
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$69.75

EAPG 3.18: COMPUTED TOMOGRAPHIC ANGIOGRAPHY

Facility

$189.07

Service Code	EAPG 00302
Min. Negotiated Rate	$189.07
Max. Negotiated Rate	$189.07
Rate for Payer: Buckeye Health Medicaid OOS	$189.07
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$189.07

EAPG 3.18: COMPUTED TOMOGRAPHY- OTHER

Facility

$134.00

Service Code	EAPG 00301
Min. Negotiated Rate	$134.00
Max. Negotiated Rate	$134.00
Rate for Payer: Buckeye Health Medicaid OOS	$134.00
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$134.00

EAPG 3.18: CONJUNCTIVITIS

Facility

$57.82

Service Code	EAPG 00555
Min. Negotiated Rate	$57.82
Max. Negotiated Rate	$57.82
Rate for Payer: Buckeye Health Medicaid OOS	$57.82
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$57.82

EAPG 3.18: CONNECTIVE TISSUE DIAGNOSES

Facility

$63.33

Service Code	EAPG 00655
Min. Negotiated Rate	$63.33
Max. Negotiated Rate	$63.33
Rate for Payer: Buckeye Health Medicaid OOS	$63.33
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$63.33

EAPG 3.18: CONSTIPATION

Facility

$78.01

Service Code	EAPG 00630
Min. Negotiated Rate	$78.01
Max. Negotiated Rate	$78.01
Rate for Payer: Buckeye Health Medicaid OOS	$78.01
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$78.01

EAPG 3.18: CONTRACEPTIVE MANAGEMENT

Facility

$149.60

Service Code	EAPG 00875
Min. Negotiated Rate	$149.60
Max. Negotiated Rate	$149.60
Rate for Payer: Buckeye Health Medicaid OOS	$149.60
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$149.60

EAPG 3.18: CONTUSIONS TO EXTERNAL ORGANS OTHER THAN HEAD TRAUMA

Facility

$88.11

Service Code	EAPG 00610
Min. Negotiated Rate	$88.11
Max. Negotiated Rate	$88.11
Rate for Payer: Buckeye Health Medicaid OOS	$88.11
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$88.11

EAPG 3.18: CORNEAL TISSUE PROCESSING

Facility

$387.31

Service Code	EAPG 00485
Min. Negotiated Rate	$387.31
Max. Negotiated Rate	$387.31
Rate for Payer: Buckeye Health Medicaid OOS	$387.31
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$387.31

EAPG 3.18: COUNSELLING OR INDIVIDUAL BRIEF PSYCHOTHERAPY

Facility

$56.90

Service Code	EAPG 00315
Min. Negotiated Rate	$56.90
Max. Negotiated Rate	$56.90
Rate for Payer: Buckeye Health Medicaid OOS	$56.90
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$56.90

EAPG 3.18: CRANIAL AND SPINAL SHUNT PROCEDURES

Facility

$1,775.03

Service Code	EAPG 00268
Min. Negotiated Rate	$1,775.03
Max. Negotiated Rate	$1,775.03
Rate for Payer: Buckeye Health Medicaid OOS	$1,775.03
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,775.03

Know your out-of-pocket cost for care.

All Charges