Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: LEVEL I OTHER UTERINE AND ADNEXA GYNECOLOGICAL PROCEDURES

Facility

$699.36

Service Code	EAPG 00207
Min. Negotiated Rate	$699.36
Max. Negotiated Rate	$699.36
Rate for Payer: Buckeye Health Medicaid OOS	$699.36
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$699.36

EAPG 3.18: LEVEL I PATHOLOGY TESTS

Facility

$21.11

Service Code	EAPG 00390
Min. Negotiated Rate	$21.11
Max. Negotiated Rate	$21.11
Rate for Payer: Buckeye Health Medicaid OOS	$21.11
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$21.11

EAPG 3.18: LEVEL I PENILE PROCEDURES

Facility

$473.58

Service Code	EAPG 00183
Min. Negotiated Rate	$473.58
Max. Negotiated Rate	$473.58
Rate for Payer: Buckeye Health Medicaid OOS	$473.58
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$473.58

EAPG 3.18: LEVEL I PERCUTANEOUS CORONARY AND INTRACARDIAC INTERVENTIONAL PROCEDURES

Facility

$1,337.23

Service Code	EAPG 00099
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 I PERINEAL AND VAGINAL GYNECOLOGICAL PROCEDURES

Facility

$648.88

Service Code	EAPG 00188
Min. Negotiated Rate	$648.88
Max. Negotiated Rate	$648.88
Rate for Payer: Buckeye Health Medicaid OOS	$648.88
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$648.88

EAPG 3.18: LEVEL I PERIODONTICS

Facility

$74.34

Service Code	EAPG 00352
Min. Negotiated Rate	$74.34
Max. Negotiated Rate	$74.34
Rate for Payer: Buckeye Health Medicaid OOS	$74.34
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$74.34

EAPG 3.18: LEVEL I PERIPHERAL ENDOVASCULAR AND TRANSCATHETER PROCEDURES

Facility

$1,108.70

Service Code	EAPG 00077
Min. Negotiated Rate	$1,108.70
Max. Negotiated Rate	$1,108.70
Rate for Payer: Buckeye Health Medicaid OOS	$1,108.70
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,108.70

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

Facility

$1,280.33

Service Code	EAPG 00078
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 I POSTERIOR SEGMENT EYE PROCEDURES

Facility

$290.94

Service Code	EAPG 00237
Min. Negotiated Rate	$290.94
Max. Negotiated Rate	$290.94
Rate for Payer: Buckeye Health Medicaid OOS	$290.94
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$290.94

EAPG 3.18: LEVEL I PROSTATE PROCEDURES

Facility

$997.65

Service Code	EAPG 00176
Min. Negotiated Rate	$997.65
Max. Negotiated Rate	$997.65
Rate for Payer: Buckeye Health Medicaid OOS	$997.65
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$997.65

EAPG 3.18: LEVEL I PROSTHODONTICS, FIXED

Facility

$42.22

Service Code	EAPG 00353
Min. Negotiated Rate	$42.22
Max. Negotiated Rate	$42.22
Rate for Payer: Buckeye Health Medicaid OOS	$42.22
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$42.22

EAPG 3.18: LEVEL I PROSTHODONTICS, REMOVABLE

Facility

$84.44

Service Code	EAPG 00356
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$84.44
Rate for Payer: Buckeye Health Medicaid OOS	$84.44
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$84.44

EAPG 3.18: LEVEL I RADIATION THERAPY

Facility

$174.38

Service Code	EAPG 00343
Min. Negotiated Rate	$174.38
Max. Negotiated Rate	$174.38
Rate for Payer: Buckeye Health Medicaid OOS	$174.38
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$174.38

EAPG 3.18: LEVEL I RADIATION TREATMENT PREPARATION & PLANNING

Facility

$234.04

Service Code	EAPG 00476
Min. Negotiated Rate	$234.04
Max. Negotiated Rate	$234.04
Rate for Payer: Buckeye Health Medicaid OOS	$234.04
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$234.04

EAPG 3.18: LEVEL I REPAIR AND PLASTIC PROCEDURES OF EYE

Facility

$383.64

Service Code	EAPG 00240
Min. Negotiated Rate	$383.64
Max. Negotiated Rate	$383.64
Rate for Payer: Buckeye Health Medicaid OOS	$383.64
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$383.64

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

Facility

$315.72

Service Code	EAPG 00009
Min. Negotiated Rate	$315.72
Max. Negotiated Rate	$315.72
Rate for Payer: Buckeye Health Medicaid OOS	$315.72
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$315.72

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

Facility

$161.53

Service Code	EAPG 00003
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

EAPG 3.18: LEVEL I SMALL AND LARGE INTESTINE SURGICAL PROCEDURES

Facility

$1,151.84

Service Code	EAPG 00127
Min. Negotiated Rate	$1,151.84
Max. Negotiated Rate	$1,151.84
Rate for Payer: Buckeye Health Medicaid OOS	$1,151.84
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,151.84

EAPG 3.18: LEVEL I SPINE PROCEDURES

Facility

$1,616.25

Service Code	EAPG 00028
Min. Negotiated Rate	$1,616.25
Max. Negotiated Rate	$1,616.25
Rate for Payer: Buckeye Health Medicaid OOS	$1,616.25
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,616.25

EAPG 3.18: LEVEL I SURGICAL PATHOLOGY TESTS

Facility

$28.45

Service Code	EAPG 00305
Min. Negotiated Rate	$28.45
Max. Negotiated Rate	$28.45
Rate for Payer: Buckeye Health Medicaid OOS	$28.45
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$28.45

EAPG 3.18: LEVEL I THORACIC AND CHEST PROCEDURES

Facility

$899.44

Service Code	EAPG 00069
Min. Negotiated Rate	$899.44
Max. Negotiated Rate	$899.44
Rate for Payer: Buckeye Health Medicaid OOS	$899.44
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$899.44

EAPG 3.18: LEVEL I UPPER GI ENDOSCOPY

Facility

$403.83

Service Code	EAPG 00134
Min. Negotiated Rate	$403.83
Max. Negotiated Rate	$403.83
Rate for Payer: Buckeye Health Medicaid OOS	$403.83
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$403.83

EAPG 3.18: LEVEL I URETHRAL PROCEDURES

Facility

$502.95

Service Code	EAPG 00166
Min. Negotiated Rate	$502.95
Max. Negotiated Rate	$502.95
Rate for Payer: Buckeye Health Medicaid OOS	$502.95
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$502.95

EAPG 3.18: LEVEL I VARICOSE VEIN AND RELATED PROCEDURES

Facility

$524.98

Service Code	EAPG 00090
Min. Negotiated Rate	$524.98
Max. Negotiated Rate	$524.98
Rate for Payer: Buckeye Health Medicaid OOS	$524.98
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$524.98

EAPG 3.18: LEVEL I VASCULAR RADIOLOGICAL PROCEDURES

Facility

$159.70

Service Code	EAPG 00277
Min. Negotiated Rate	$159.70
Max. Negotiated Rate	$159.70
Rate for Payer: Buckeye Health Medicaid OOS	$159.70
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$159.70

Know your out-of-pocket cost for care.

All Charges