Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: LEVEL III VASCULAR RADIOLOGICAL PROCEDURES

Facility

$463.49

Service Code	EAPG 00280
Min. Negotiated Rate	$463.49
Max. Negotiated Rate	$463.49
Rate for Payer: Buckeye Health Medicaid OOS	$463.49
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$463.49

EAPG 3.18: LEVEL II JOINT, TENDON, OR LIGAMENT INJECTION PROCEDURES

Facility

$266.16

Service Code	EAPG 00050
Min. Negotiated Rate	$266.16
Max. Negotiated Rate	$266.16
Rate for Payer: Buckeye Health Medicaid OOS	$266.16
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$266.16

EAPG 3.18: LEVEL II KIDNEY AND URETERAL PROCEDURES

Facility

$724.14

Service Code	EAPG 00171
Min. Negotiated Rate	$724.14
Max. Negotiated Rate	$724.14
Rate for Payer: Buckeye Health Medicaid OOS	$724.14
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$724.14

EAPG 3.18: LEVEL II KNEE AND LOWER LEG PROCEDURES

Facility

$1,002.24

Service Code	EAPG 00052
Min. Negotiated Rate	$1,002.24
Max. Negotiated Rate	$1,002.24
Rate for Payer: Buckeye Health Medicaid OOS	$1,002.24
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,002.24

EAPG 3.18: LEVEL II LAPAROSCOPY

Facility

$1,261.97

Service Code	EAPG 00146
Min. Negotiated Rate	$1,261.97
Max. Negotiated Rate	$1,261.97
Rate for Payer: Buckeye Health Medicaid OOS	$1,261.97
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,261.97

EAPG 3.18: LEVEL II LOWER AIRWAY ENDOSCOPY

Facility

$645.21

Service Code	EAPG 00071
Min. Negotiated Rate	$645.21
Max. Negotiated Rate	$645.21
Rate for Payer: Buckeye Health Medicaid OOS	$645.21
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$645.21

EAPG 3.18: LEVEL II LOWER GI ENDOSCOPY

Facility

$438.71

Service Code	EAPG 00137
Min. Negotiated Rate	$438.71
Max. Negotiated Rate	$438.71
Rate for Payer: Buckeye Health Medicaid OOS	$438.71
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$438.71

EAPG 3.18: LEVEL II MAXILLOFACIAL PROSTHETICS

Facility

$122.99

Service Code	EAPG 00360
Min. Negotiated Rate	$122.99
Max. Negotiated Rate	$122.99
Rate for Payer: Buckeye Health Medicaid OOS	$122.99
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$122.99

EAPG 3.18: LEVEL II MICROBIOLOGY TESTS

Facility

$22.03

Service Code	EAPG 00397
Min. Negotiated Rate	$22.03
Max. Negotiated Rate	$22.03
Rate for Payer: Buckeye Health Medicaid OOS	$22.03
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$22.03

EAPG 3.18: LEVEL I IMMUNIZATION

Facility

$16.52

Service Code	EAPG 00414
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$16.52
Rate for Payer: Buckeye Health Medicaid OOS	$16.52
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$16.52

EAPG 3.18: LEVEL I IMMUNOLOGY TESTS

Facility

$6.42

Service Code	EAPG 00394
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 II NERVE PROCEDURE W OR W/O NEUROLOGICAL DEVICE

Facility

$1,775.03

Service Code	EAPG 00218
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

EAPG 3.18: LEVEL II NERVOUS SYSTEM INJECTIONS INCLUDING CRANIAL TAP

Facility

$279.01

Service Code	EAPG 00220
Min. Negotiated Rate	$279.01
Max. Negotiated Rate	$279.01
Rate for Payer: Buckeye Health Medicaid OOS	$279.01
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$279.01

EAPG 3.18: LEVEL II ORAL AND MAXILLOFACIAL PROCEDURES

Facility

$190.90

Service Code	EAPG 00368
Min. Negotiated Rate	$190.90
Max. Negotiated Rate	$190.90
Rate for Payer: Buckeye Health Medicaid OOS	$190.90
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$190.90

EAPG 3.18: LEVEL II OTHER UTERINE AND ADNEXA GYNECOLOGICAL PROCEDURES

Facility

$864.57

Service Code	EAPG 00208
Min. Negotiated Rate	$864.57
Max. Negotiated Rate	$864.57
Rate for Payer: Buckeye Health Medicaid OOS	$864.57
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$864.57

EAPG 3.18: LEVEL II PATHOLOGY TESTS

Facility

$39.47

Service Code	EAPG 00391
Min. Negotiated Rate	$39.47
Max. Negotiated Rate	$39.47
Rate for Payer: Buckeye Health Medicaid OOS	$39.47
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$39.47

EAPG 3.18: LEVEL II PENILE PROCEDURES

Facility

$496.53

Service Code	EAPG 00187
Min. Negotiated Rate	$496.53
Max. Negotiated Rate	$496.53
Rate for Payer: Buckeye Health Medicaid OOS	$496.53
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$496.53

EAPG 3.18: LEVEL II PERCUTANEOUS CORONARY AND INTRACARDIAC INTERVENTIONAL PROCEDURES

Facility

$1,373.95

Service Code	EAPG 00121
Min. Negotiated Rate	$1,373.95
Max. Negotiated Rate	$1,373.95
Rate for Payer: Buckeye Health Medicaid OOS	$1,373.95
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,373.95

EAPG 3.18: LEVEL II PERINEAL AND VAGINAL GYNECOLOGICAL PROCEDURES

Facility

$731.49

Service Code	EAPG 00189
Min. Negotiated Rate	$731.49
Max. Negotiated Rate	$731.49
Rate for Payer: Buckeye Health Medicaid OOS	$731.49
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$731.49

EAPG 3.18: LEVEL II PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES

Facility

$1,337.23

Service Code	EAPG 00079
Min. Negotiated Rate	$1,337.23
Max. Negotiated Rate	$1,337.23
Rate for Payer: Buckeye Health Medicaid OOS	$1,337.23
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,337.23

EAPG 3.18: LEVEL II PERIPHERAL VASCULAR REPAIR, LIGATION OR RECONSTRUCTION

Facility

$1,280.33

Service Code	EAPG 00091
Min. Negotiated Rate	$1,280.33
Max. Negotiated Rate	$1,280.33
Rate for Payer: Buckeye Health Medicaid OOS	$1,280.33
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,280.33

EAPG 3.18: LEVEL II POSTERIOR SEGMENT EYE PROCEDURES

Facility

$1,391.38

Service Code	EAPG 00238
Min. Negotiated Rate	$1,391.38
Max. Negotiated Rate	$1,391.38
Rate for Payer: Buckeye Health Medicaid OOS	$1,391.38
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,391.38

EAPG 3.18: LEVEL II PROSTATE PROCEDURES

Facility

$1,349.17

Service Code	EAPG 00184
Min. Negotiated Rate	$1,349.17
Max. Negotiated Rate	$1,349.17
Rate for Payer: Buckeye Health Medicaid OOS	$1,349.17
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,349.17

EAPG 3.18: LEVEL II PROSTHODONTICS, FIXED

Facility

$156.03

Service Code	EAPG 00354
Min. Negotiated Rate	$156.03
Max. Negotiated Rate	$156.03
Rate for Payer: Buckeye Health Medicaid OOS	$156.03
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$156.03

EAPG 3.18: LEVEL II PROSTHODONTICS, REMOVABLE

Facility

$161.53

Service Code	EAPG 00357
Min. Negotiated Rate	$161.53
Max. Negotiated Rate	$161.53
Rate for Payer: Buckeye Health Medicaid OOS	$161.53
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$161.53

Know your out-of-pocket cost for care.

All Charges