Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: LEVEL II RADIATION THERAPY

Facility

$80.77

Service Code	EAPG 00347
Min. Negotiated Rate	$80.77
Max. Negotiated Rate	$80.77
Rate for Payer: Buckeye Health Medicaid OOS	$80.77
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$80.77

EAPG 3.18: LEVEL II RADIATION TREATMENT PREPARATION & PLANNING

Facility

$221.19

Service Code	EAPG 00477
Min. Negotiated Rate	$221.19
Max. Negotiated Rate	$221.19
Rate for Payer: Buckeye Health Medicaid OOS	$221.19
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$221.19

EAPG 3.18: LEVEL II REPAIR AND PLASTIC PROCEDURES OF EYE

Facility

$955.43

Service Code	EAPG 00241
Min. Negotiated Rate	$955.43
Max. Negotiated Rate	$955.43
Rate for Payer: Buckeye Health Medicaid OOS	$955.43
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$955.43

EAPG 3.18: LEVEL II SHOULDER AND UPPER ARM PROCEDURES

Facility

$1,140.83

Service Code	EAPG 00058
Min. Negotiated Rate	$1,140.83
Max. Negotiated Rate	$1,140.83
Rate for Payer: Buckeye Health Medicaid OOS	$1,140.83
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,140.83

EAPG 3.18: LEVEL II SKIN EXCISIONS, BIOPSIES, AND REPAIRS

Facility

$619.51

Service Code	EAPG 00010
Min. Negotiated Rate	$619.51
Max. Negotiated Rate	$619.51
Rate for Payer: Buckeye Health Medicaid OOS	$619.51
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$619.51

EAPG 3.18: LEVEL II SKIN INCISION AND DRAINAGE, DEBRIDEMENT, DESTRUCTION, OTHER RELATED PX

Facility

$304.71

Service Code	EAPG 00004
Min. Negotiated Rate	$304.71
Max. Negotiated Rate	$304.71
Rate for Payer: Buckeye Health Medicaid OOS	$304.71
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$304.71

EAPG 3.18: LEVEL II SMALL AND LARGE INTESTINE SURGICAL PROCEDURES

Facility

$1,262.89

Service Code	EAPG 00128
Min. Negotiated Rate	$1,262.89
Max. Negotiated Rate	$1,262.89
Rate for Payer: Buckeye Health Medicaid OOS	$1,262.89
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,262.89

EAPG 3.18: LEVEL II SPINE PROCEDURES

Facility

$1,960.42

Service Code	EAPG 00029
Min. Negotiated Rate	$1,960.42
Max. Negotiated Rate	$1,960.42
Rate for Payer: Buckeye Health Medicaid OOS	$1,960.42
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,960.42

EAPG 3.18: LEVEL II SURGICAL PATHOLOGY TESTS

Facility

$40.38

Service Code	EAPG 00306
Min. Negotiated Rate	$40.38
Max. Negotiated Rate	$40.38
Rate for Payer: Buckeye Health Medicaid OOS	$40.38
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$40.38

EAPG 3.18: LEVEL II THORACIC AND CHEST PROCEDURES

Facility

$1,167.44

Service Code	EAPG 00070
Min. Negotiated Rate	$1,167.44
Max. Negotiated Rate	$1,167.44
Rate for Payer: Buckeye Health Medicaid OOS	$1,167.44
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,167.44

EAPG 3.18: LEVEL II UPPER GI ENDOSCOPY

Facility

$461.65

Service Code	EAPG 00135
Min. Negotiated Rate	$461.65
Max. Negotiated Rate	$461.65
Rate for Payer: Buckeye Health Medicaid OOS	$461.65
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$461.65

EAPG 3.18: LEVEL II URETHRAL PROCEDURES

Facility

$1,267.48

Service Code	EAPG 00167
Min. Negotiated Rate	$1,267.48
Max. Negotiated Rate	$1,267.48
Rate for Payer: Buckeye Health Medicaid OOS	$1,267.48
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,267.48

EAPG 3.18: LEVEL II VARICOSE VEIN AND RELATED PROCEDURES

Facility

$1,200.48

Service Code	EAPG 00103
Min. Negotiated Rate	$1,200.48
Max. Negotiated Rate	$1,200.48
Rate for Payer: Buckeye Health Medicaid OOS	$1,200.48
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,200.48

EAPG 3.18: LEVEL II VASCULAR RADIOLOGICAL PROCEDURES

Facility

$177.14

Service Code	EAPG 00279
Min. Negotiated Rate	$177.14
Max. Negotiated Rate	$177.14
Rate for Payer: Buckeye Health Medicaid OOS	$177.14
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$177.14

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

Facility

$146.85

Service Code	EAPG 00049
Min. Negotiated Rate	$146.85
Max. Negotiated Rate	$146.85
Rate for Payer: Buckeye Health Medicaid OOS	$146.85
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$146.85

EAPG 3.18: LEVEL I KIDNEY AND URETERAL PROCEDURES

Facility

$548.84

Service Code	EAPG 00170
Min. Negotiated Rate	$548.84
Max. Negotiated Rate	$548.84
Rate for Payer: Buckeye Health Medicaid OOS	$548.84
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$548.84

EAPG 3.18: LEVEL I KNEE AND LOWER LEG PROCEDURES

Facility

$879.25

Service Code	EAPG 00026
Min. Negotiated Rate	$879.25
Max. Negotiated Rate	$879.25
Rate for Payer: Buckeye Health Medicaid OOS	$879.25
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$879.25

EAPG 3.18: LEVEL I LAPAROSCOPY

Facility

$930.65

Service Code	EAPG 00145
Min. Negotiated Rate	$930.65
Max. Negotiated Rate	$930.65
Rate for Payer: Buckeye Health Medicaid OOS	$930.65
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$930.65

EAPG 3.18: LEVEL I LOWER AIRWAY ENDOSCOPY

Facility

$586.47

Service Code	EAPG 00064
Min. Negotiated Rate	$586.47
Max. Negotiated Rate	$586.47
Rate for Payer: Buckeye Health Medicaid OOS	$586.47
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$586.47

EAPG 3.18: LEVEL I LOWER GI ENDOSCOPY

Facility

$387.31

Service Code	EAPG 00136
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: LEVEL I MAXILLOFACIAL PROSTHETICS

Facility

$23.86

Service Code	EAPG 00359
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 I MICROBIOLOGY TESTS

Facility

$5.51

Service Code	EAPG 00396
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$5.51
Rate for Payer: Buckeye Health Medicaid OOS	$5.51
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$5.51

EAPG 3.18: LEVEL I NERVE PROCEDURE W OR W/O NEUROLOGICAL DEVICE

Facility

$664.49

Service Code	EAPG 00217
Min. Negotiated Rate	$664.49
Max. Negotiated Rate	$664.49
Rate for Payer: Buckeye Health Medicaid OOS	$664.49
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$664.49

EAPG 3.18: LEVEL I NERVOUS SYSTEM INJECTIONS INCLUDING CRANIAL TAP

Facility

$232.20

Service Code	EAPG 00214
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Buckeye Health Medicaid OOS	$232.20
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$232.20

EAPG 3.18: LEVEL I ORAL AND MAXILLOFACIAL PROCEDURES

Facility

$68.83

Service Code	EAPG 00367
Min. Negotiated Rate	$68.83
Max. Negotiated Rate	$68.83
Rate for Payer: Buckeye Health Medicaid OOS	$68.83
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$68.83

Know your out-of-pocket cost for care.

All Charges