Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: LEVEL I FETAL PROCEDURES

Facility

$119.31

Service Code	EAPG 00191
Min. Negotiated Rate	$119.31
Max. Negotiated Rate	$119.31
Rate for Payer: Buckeye Health Medicaid OOS	$119.31
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$119.31

EAPG 3.18: LEVEL I FOOT PROCEDURES

Facility

$816.84

Service Code	EAPG 00035
Min. Negotiated Rate	$816.84
Max. Negotiated Rate	$816.84
Rate for Payer: Buckeye Health Medicaid OOS	$816.84
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$816.84

EAPG 3.18: LEVEL I FOREARM AND WRIST PROCEDURES

Facility

$994.90

Service Code	EAPG 00023
Min. Negotiated Rate	$994.90
Max. Negotiated Rate	$994.90
Rate for Payer: Buckeye Health Medicaid OOS	$994.90
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$994.90

EAPG 3.18: LEVEL I GASTROINTESTINAL PROCEDURES

Facility

$602.99

Service Code	EAPG 00143
Min. Negotiated Rate	$602.99
Max. Negotiated Rate	$602.99
Rate for Payer: Buckeye Health Medicaid OOS	$602.99
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$602.99

EAPG 3.18: LEVEL I HAND PROCEDURES

Facility

$634.20

Service Code	EAPG 00033
Min. Negotiated Rate	$634.20
Max. Negotiated Rate	$634.20
Rate for Payer: Buckeye Health Medicaid OOS	$634.20
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$634.20

EAPG 3.18: LEVEL I HEMATOLOGY TESTS

Facility

$6.42

Service Code	EAPG 00408
Min. Negotiated Rate	$6.42
Max. Negotiated Rate	$6.42
Rate for Payer: Buckeye Health Medicaid OOS	$6.42
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$6.42

EAPG 3.18: LEVEL I HEPATOBILIARY AND PANCREAS PROCEDURES

Facility

$725.06

Service Code	EAPG 00151
Min. Negotiated Rate	$725.06
Max. Negotiated Rate	$725.06
Rate for Payer: Buckeye Health Medicaid OOS	$725.06
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$725.06

EAPG 3.18: LEVEL I HYSTERECTOMY AND MYOMECTOMY PROCEDURES

Facility

$601.16

Service Code	EAPG 00204
Min. Negotiated Rate	$601.16
Max. Negotiated Rate	$601.16
Rate for Payer: Buckeye Health Medicaid OOS	$601.16
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$601.16

EAPG 3.18: LEVEL II ADJUNCTIVE GENERAL DENTAL SERVICES

Facility

$120.23

Service Code	EAPG 00351
Min. Negotiated Rate	$120.23
Max. Negotiated Rate	$120.23
Rate for Payer: Buckeye Health Medicaid OOS	$120.23
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$120.23

EAPG 3.18: LEVEL II ALLERGY TESTS

Facility

$126.66

Service Code	EAPG 02016
Min. Negotiated Rate	$126.66
Max. Negotiated Rate	$126.66
Rate for Payer: Buckeye Health Medicaid OOS	$126.66
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$126.66

EAPG 3.18: LEVEL II ANAL AND RECTAL PROCEDURES

Facility

$768.20

Service Code	EAPG 00142
Min. Negotiated Rate	$768.20
Max. Negotiated Rate	$768.20
Rate for Payer: Buckeye Health Medicaid OOS	$768.20
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$768.20

EAPG 3.18: LEVEL II ANCLLARY THERAPEUTIC SERVICES

Facility

$35.79

Service Code	EAPG 00269
Min. Negotiated Rate	$35.79
Max. Negotiated Rate	$35.79
Rate for Payer: Buckeye Health Medicaid OOS	$35.79
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$35.79

EAPG 3.18: LEVEL II ANTERIOR SEGMENT EYE PROCEDURES

Facility

$1,098.61

Service Code	EAPG 00235
Min. Negotiated Rate	$1,098.61
Max. Negotiated Rate	$1,098.61
Rate for Payer: Buckeye Health Medicaid OOS	$1,098.61
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,098.61

EAPG 3.18: LEVEL II ARTHROPLASTY

Facility

$1,750.24

Service Code	EAPG 00047
Min. Negotiated Rate	$1,750.24
Max. Negotiated Rate	$1,750.24
Rate for Payer: Buckeye Health Medicaid OOS	$1,750.24
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,750.24

EAPG 3.18: LEVEL II ARTHROSCOPY

Facility

$1,735.56

Service Code	EAPG 00038
Min. Negotiated Rate	$1,735.56
Max. Negotiated Rate	$1,735.56
Rate for Payer: Buckeye Health Medicaid OOS	$1,735.56
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,735.56

EAPG 3.18: LEVEL II BLADDER AND URETERAL PROCEDURES

Facility

$974.70

Service Code	EAPG 00174
Min. Negotiated Rate	$974.70
Max. Negotiated Rate	$974.70
Rate for Payer: Buckeye Health Medicaid OOS	$974.70
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$974.70

EAPG 3.18: LEVEL II BLOOD AND BLOOD PRODUCT EXCHANGE

Facility

$1,023.35

Service Code	EAPG 00114
Min. Negotiated Rate	$1,023.35
Max. Negotiated Rate	$1,023.35
Rate for Payer: Buckeye Health Medicaid OOS	$1,023.35
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,023.35

EAPG 3.18: LEVEL II BLOOD AND TISSUE TYPING TESTS

Facility

$23.86

Service Code	EAPG 00393
Min. Negotiated Rate	$23.86
Max. Negotiated Rate	$23.86
Rate for Payer: Buckeye Health Medicaid OOS	$23.86
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$23.86

EAPG 3.18: LEVEL II BLOOD PRODUCTS

Facility

$334.08

Service Code	EAPG 02062
Min. Negotiated Rate	$334.08
Max. Negotiated Rate	$334.08
Rate for Payer: Buckeye Health Medicaid OOS	$334.08
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$334.08

EAPG 3.18: LEVEL II BRACHYTHERAPY SOURCES

Facility

$691.10

Service Code	EAPG 00336
Min. Negotiated Rate	$691.10
Max. Negotiated Rate	$691.10
Rate for Payer: Buckeye Health Medicaid OOS	$691.10
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$691.10

EAPG 3.18: LEVEL II BREAST PROCEDURES

Facility

$1,110.54

Service Code	EAPG 00021
Min. Negotiated Rate	$1,110.54
Max. Negotiated Rate	$1,110.54
Rate for Payer: Buckeye Health Medicaid OOS	$1,110.54
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,110.54

EAPG 3.18: LEVEL II CENTRAL VENOUS ACCESS PROCEDURES

Facility

$694.77

Service Code	EAPG 00083
Min. Negotiated Rate	$694.77
Max. Negotiated Rate	$694.77
Rate for Payer: Buckeye Health Medicaid OOS	$694.77
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$694.77

EAPG 3.18: LEVEL II CHEMISTRY TESTS

Facility

$19.27

Service Code	EAPG 00401
Min. Negotiated Rate	$19.27
Max. Negotiated Rate	$19.27
Rate for Payer: Buckeye Health Medicaid OOS	$19.27
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$19.27

EAPG 3.18: LEVEL II CLOTTING TESTS

Facility

$22.95

Service Code	EAPG 00407
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$22.95
Rate for Payer: Buckeye Health Medicaid OOS	$22.95
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$22.95

EAPG 3.18: LEVEL II COMPUTED TOMOGRAPHY

Facility

$178.05

Service Code	EAPG 00300
Min. Negotiated Rate	$178.05
Max. Negotiated Rate	$178.05
Rate for Payer: Buckeye Health Medicaid OOS	$178.05
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$178.05

Know your out-of-pocket cost for care.

All Charges