Cameron Memorial Community Hospital

All Charges

Charge

Type

Setting

Price

EAPG 3.18: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$69.75

Service Code	EAPG 00660
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: OTHER OPHTHALMIC SYSTEM DIAGNOSES

Facility

$68.83

Service Code	EAPG 00553
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

EAPG 3.18: OTHER PATHOLOGICAL FRACTURES W/O MUSCULOSKELETAL MALIGNANCY

Facility

$78.93

Service Code	EAPG 00649
Min. Negotiated Rate	$78.93
Max. Negotiated Rate	$78.93
Rate for Payer: Buckeye Health Medicaid OOS	$78.93
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$78.93

EAPG 3.18: OTHER RESPIRATORY SYSTEM DIAGNOSES

Facility

$70.67

Service Code	EAPG 00576
Min. Negotiated Rate	$70.67
Max. Negotiated Rate	$70.67
Rate for Payer: Buckeye Health Medicaid OOS	$70.67
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$70.67

EAPG 3.18: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DIAGNOSES

Facility

$59.66

Service Code	EAPG 00675
Min. Negotiated Rate	$59.66
Max. Negotiated Rate	$59.66
Rate for Payer: Buckeye Health Medicaid OOS	$59.66
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$59.66

EAPG 3.18: OTORHINOLARYNGOLOGIC FUNCTION TESTS

Facility

$67.92

Service Code	EAPG 00251
Min. Negotiated Rate	$67.92
Max. Negotiated Rate	$67.92
Rate for Payer: Buckeye Health Medicaid OOS	$67.92
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$67.92

EAPG 3.18: PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT

Facility

$3,182.01

Service Code	EAPG 00086
Min. Negotiated Rate	$3,182.01
Max. Negotiated Rate	$3,182.01
Rate for Payer: Buckeye Health Medicaid OOS	$3,182.01
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$3,182.01

EAPG 3.18: PAIN

Facility

$69.75

Service Code	EAPG 00663
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: PANCREAS DIAGNOSES EXCEPT MALIGNANCY

Facility

$62.41

Service Code	EAPG 00635
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: PAP SMEARS

Facility

$16.52

Service Code	EAPG 00392
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: PARTIAL THICKNESS BURNS W OR W/O SKIN GRAFT

Facility

$78.93

Service Code	EAPG 00861
Min. Negotiated Rate	$78.93
Max. Negotiated Rate	$78.93
Rate for Payer: Buckeye Health Medicaid OOS	$78.93
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$78.93

EAPG 3.18: PATHOLOGY CONSULTATION AND INTERPRETATION

Facility

$33.96

Service Code	EAPG 00158
Min. Negotiated Rate	$33.96
Max. Negotiated Rate	$33.96
Rate for Payer: Buckeye Health Medicaid OOS	$33.96
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$33.96

EAPG 3.18: PELVIS, FEMUR AND UPPER LEG PROCEDURES

Facility

$1,097.69

Service Code	EAPG 00027
Min. Negotiated Rate	$1,097.69
Max. Negotiated Rate	$1,097.69
Rate for Payer: Buckeye Health Medicaid OOS	$1,097.69
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,097.69

EAPG 3.18: PEPTIC ULCER AND GASTRITIS

Facility

$78.01

Service Code	EAPG 00621
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: PERCUTANEOUS INTRA-ABDOMINAL OR INTRATHORACIC VASCULAR PROCEDURES

Facility

$775.54

Service Code	EAPG 00122
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Buckeye Health Medicaid OOS	$775.54
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$775.54

EAPG 3.18: PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$1,321.63

Service Code	EAPG 00265
Min. Negotiated Rate	$1,321.63
Max. Negotiated Rate	$1,321.63
Rate for Payer: Buckeye Health Medicaid OOS	$1,321.63
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,321.63

EAPG 3.18: PERIPHERAL AND CRANIAL NERVE DIAGNOSES

Facility

$63.33

Service Code	EAPG 00527
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: PERIPHERAL AND OTHER VASCULAR DIAGNOSES

Facility

$69.75

Service Code	EAPG 00596
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: PERIPHERAL AND OTHER VASCULAR RELATED INJURIES

Facility

$71.59

Service Code	EAPG 00548
Min. Negotiated Rate	$71.59
Max. Negotiated Rate	$71.59
Rate for Payer: Buckeye Health Medicaid OOS	$71.59
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$71.59

EAPG 3.18: PERIPHERAL, CRANIAL, AND AUTONOMIC NERVE INJURIES

Facility

$67.00

Service Code	EAPG 00545
Min. Negotiated Rate	$67.00
Max. Negotiated Rate	$67.00
Rate for Payer: Buckeye Health Medicaid OOS	$67.00
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$67.00

EAPG 3.18: PERIPHERAL VASCULAR BYPASS PROCEDURES

Facility

$1,176.62

Service Code	EAPG 00123
Min. Negotiated Rate	$1,176.62
Max. Negotiated Rate	$1,176.62
Rate for Payer: Buckeye Health Medicaid OOS	$1,176.62
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$1,176.62

EAPG 3.18: PERSONALITY AND IMPULSE CONTROL DIAGNOSES

Facility

$60.57

Service Code	EAPG 00822
Min. Negotiated Rate	$60.57
Max. Negotiated Rate	$60.57
Rate for Payer: Buckeye Health Medicaid OOS	$60.57
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$60.57

EAPG 3.18: PET SCANS

Facility

$761.77

Service Code	EAPG 00290
Min. Negotiated Rate	$761.77
Max. Negotiated Rate	$761.77
Rate for Payer: Buckeye Health Medicaid OOS	$761.77
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$761.77

EAPG 3.18: PHARMACOTHERAPY BY EXTENDED INFUSION

Facility

$357.94

Service Code	EAPG 00110
Min. Negotiated Rate	$357.94
Max. Negotiated Rate	$357.94
Rate for Payer: Buckeye Health Medicaid OOS	$357.94
Rate for Payer: Molina Healthcare of OH Medicaid OOS/Medicare	$357.94

EAPG 3.18: PHARMACOTHERAPY EXCEPT BY EXTENDED INFUSION

Facility

$134.00

Service Code	EAPG 00111
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

Know your out-of-pocket cost for care.

All Charges