Cameron Memorial Community Hospital

All Charges

Charge

Type

Price

OUTPATIENT EAPG 00165: LEVEL III BLADDER AND KIDNEY PROCEDURES

Facility OP

$1,184.07

Service Code	EAPG 00165
Hospital Charge Code	EAPG 00165
Min. Negotiated Rate	$1,184.07
Max. Negotiated Rate	$1,184.07
Rate for Payer: Buckeye Health Medicaid OOS	$1,184.07
Rate for Payer: Molina Healthcare of OH Medicare	$1,184.07

OUTPATIENT EAPG 00166: LEVEL I URETHRA AND PROSTATE PROCEDURES

Facility OP

$365.34

Service Code	EAPG 00166
Hospital Charge Code	EAPG 00166
Min. Negotiated Rate	$365.34
Max. Negotiated Rate	$365.34
Rate for Payer: Buckeye Health Medicaid OOS	$365.34
Rate for Payer: Molina Healthcare of OH Medicare	$365.34

OUTPATIENT EAPG 00167: LEVEL II URETHRA AND PROSTATE PROCEDURES

Facility OP

$587.83

Service Code	EAPG 00167
Hospital Charge Code	EAPG 00167
Min. Negotiated Rate	$587.83
Max. Negotiated Rate	$587.83
Rate for Payer: Buckeye Health Medicaid OOS	$587.83
Rate for Payer: Molina Healthcare of OH Medicare	$587.83

OUTPATIENT EAPG 00168: HEMODIALYSIS

Facility OP

$235.07

Service Code	EAPG 00168
Hospital Charge Code	EAPG 00168
Min. Negotiated Rate	$235.07
Max. Negotiated Rate	$235.07
Rate for Payer: Buckeye Health Medicaid OOS	$235.07
Rate for Payer: Molina Healthcare of OH Medicare	$235.07

OUTPATIENT EAPG 00169: PERITONEAL DIALYSIS

Facility OP

$136.52

Service Code	EAPG 00169
Hospital Charge Code	EAPG 00169
Min. Negotiated Rate	$136.52
Max. Negotiated Rate	$136.52
Rate for Payer: Buckeye Health Medicaid OOS	$136.52
Rate for Payer: Molina Healthcare of OH Medicare	$136.52

OUTPATIENT EAPG 00180: TESTICULAR AND EPIDIDYMAL PROCEDURES

Facility OP

$834.16

Service Code	EAPG 00180
Hospital Charge Code	EAPG 00180
Min. Negotiated Rate	$834.16
Max. Negotiated Rate	$834.16
Rate for Payer: Buckeye Health Medicaid OOS	$834.16
Rate for Payer: Molina Healthcare of OH Medicare	$834.16

OUTPATIENT EAPG 00181: CIRCUMCISION

Facility OP

$578.52

Service Code	EAPG 00181
Hospital Charge Code	EAPG 00181
Min. Negotiated Rate	$578.52
Max. Negotiated Rate	$578.52
Rate for Payer: Buckeye Health Medicaid OOS	$578.52
Rate for Payer: Molina Healthcare of OH Medicare	$578.52

OUTPATIENT EAPG 00182: INSERTION OF PENILE PROSTHESIS

Facility OP

$1,846.84

Service Code	EAPG 00182
Hospital Charge Code	EAPG 00182
Min. Negotiated Rate	$1,846.84
Max. Negotiated Rate	$1,846.84
Rate for Payer: Buckeye Health Medicaid OOS	$1,846.84
Rate for Payer: Molina Healthcare of OH Medicare	$1,846.84

OUTPATIENT EAPG 00183: OTHER PENILE PROCEDURES

Facility OP

$1,015.52

Service Code	EAPG 00183
Hospital Charge Code	EAPG 00183
Min. Negotiated Rate	$1,015.52
Max. Negotiated Rate	$1,015.52
Rate for Payer: Buckeye Health Medicaid OOS	$1,015.52
Rate for Payer: Molina Healthcare of OH Medicare	$1,015.52

OUTPATIENT EAPG 00184: DESTRUCTION OR RESECTION OF PROSTATE

Facility OP

$1,134.05

Service Code	EAPG 00184
Hospital Charge Code	EAPG 00184
Min. Negotiated Rate	$1,134.05
Max. Negotiated Rate	$1,134.05
Rate for Payer: Buckeye Health Medicaid OOS	$1,134.05
Rate for Payer: Molina Healthcare of OH Medicare	$1,134.05

OUTPATIENT EAPG 00185: PROSTATE NEEDLE AND PUNCH BIOPSY

Facility OP

$587.08

Service Code	EAPG 00185
Hospital Charge Code	EAPG 00185
Min. Negotiated Rate	$587.08
Max. Negotiated Rate	$587.08
Rate for Payer: Buckeye Health Medicaid OOS	$587.08
Rate for Payer: Molina Healthcare of OH Medicare	$587.08

OUTPATIENT EAPG 00190: ARTIFICIAL FERTILIZATION

Facility OP

$124.36

Service Code	EAPG 00190
Hospital Charge Code	EAPG 00190
Min. Negotiated Rate	$124.36
Max. Negotiated Rate	$124.36
Rate for Payer: Buckeye Health Medicaid OOS	$124.36
Rate for Payer: Molina Healthcare of OH Medicare	$124.36

OUTPATIENT EAPG 00191: LEVEL I FETAL PROCEDURES

Facility OP

$110.32

Service Code	EAPG 00191
Hospital Charge Code	EAPG 00191
Min. Negotiated Rate	$110.32
Max. Negotiated Rate	$110.32
Rate for Payer: Buckeye Health Medicaid OOS	$110.32
Rate for Payer: Molina Healthcare of OH Medicare	$110.32

OUTPATIENT EAPG 00192: LEVEL II FETAL PROCEDURES

Facility OP

$219.67

Service Code	EAPG 00192
Hospital Charge Code	EAPG 00192
Min. Negotiated Rate	$219.67
Max. Negotiated Rate	$219.67
Rate for Payer: Buckeye Health Medicaid OOS	$219.67
Rate for Payer: Molina Healthcare of OH Medicare	$219.67

OUTPATIENT EAPG 00193: TREATMENT OF INCOMPLETE ABORTION

Facility OP

$662.92

Service Code	EAPG 00193
Hospital Charge Code	EAPG 00193
Min. Negotiated Rate	$662.92
Max. Negotiated Rate	$662.92
Rate for Payer: Buckeye Health Medicaid OOS	$662.92
Rate for Payer: Molina Healthcare of OH Medicare	$662.92

OUTPATIENT EAPG 00194: THERAPEUTIC ABORTION

Facility OP

$520.18

Service Code	EAPG 00194
Hospital Charge Code	EAPG 00194
Min. Negotiated Rate	$520.18
Max. Negotiated Rate	$520.18
Rate for Payer: Buckeye Health Medicaid OOS	$520.18
Rate for Payer: Molina Healthcare of OH Medicare	$520.18

OUTPATIENT EAPG 00195: VAGINAL DELIVERY

Facility OP

$926.89

Service Code	EAPG 00195
Hospital Charge Code	EAPG 00195
Min. Negotiated Rate	$926.89
Max. Negotiated Rate	$926.89
Rate for Payer: Buckeye Health Medicaid OOS	$926.89
Rate for Payer: Molina Healthcare of OH Medicare	$926.89

OUTPATIENT EAPG 00196: LEVEL I FEMALE REPRODUCTIVE PROCEDURES

Facility OP

$624.94

Service Code	EAPG 00196
Hospital Charge Code	EAPG 00196
Min. Negotiated Rate	$624.94
Max. Negotiated Rate	$624.94
Rate for Payer: Buckeye Health Medicaid OOS	$624.94
Rate for Payer: Molina Healthcare of OH Medicare	$624.94

OUTPATIENT EAPG 00197: LEVEL II FEMALE REPRODUCTIVE PROCEDURES

Facility OP

$890.01

Service Code	EAPG 00197
Hospital Charge Code	EAPG 00197
Min. Negotiated Rate	$890.01
Max. Negotiated Rate	$890.01
Rate for Payer: Buckeye Health Medicaid OOS	$890.01
Rate for Payer: Molina Healthcare of OH Medicare	$890.01

OUTPATIENT EAPG 00198: LEVEL III FEMALE REPRODUCTIVE PROCEDURES

Facility OP

$1,148.55

Service Code	EAPG 00198
Hospital Charge Code	EAPG 00198
Min. Negotiated Rate	$1,148.55
Max. Negotiated Rate	$1,148.55
Rate for Payer: Buckeye Health Medicaid OOS	$1,148.55
Rate for Payer: Molina Healthcare of OH Medicare	$1,148.55

OUTPATIENT EAPG 00199: DILATION AND CURETTAGE

Facility OP

$629.74

Service Code	EAPG 00199
Hospital Charge Code	EAPG 00199
Min. Negotiated Rate	$629.74
Max. Negotiated Rate	$629.74
Rate for Payer: Buckeye Health Medicaid OOS	$629.74
Rate for Payer: Molina Healthcare of OH Medicare	$629.74

OUTPATIENT EAPG 00200: HYSTEROSCOPY

Facility OP

$759.48

Service Code	EAPG 00200
Hospital Charge Code	EAPG 00200
Min. Negotiated Rate	$759.48
Max. Negotiated Rate	$759.48
Rate for Payer: Buckeye Health Medicaid OOS	$759.48
Rate for Payer: Molina Healthcare of OH Medicare	$759.48

OUTPATIENT EAPG 00201: COLPOSCOPY

Facility OP

$197.67

Service Code	EAPG 00201
Hospital Charge Code	EAPG 00201
Min. Negotiated Rate	$197.67
Max. Negotiated Rate	$197.67
Rate for Payer: Buckeye Health Medicaid OOS	$197.67
Rate for Payer: Molina Healthcare of OH Medicare	$197.67

OUTPATIENT EAPG 00203: GLOBAL ANTEPARTUM AND POSTPARTUM VISITS

Facility OP

$226.28

Service Code	EAPG 00203
Hospital Charge Code	EAPG 00203
Min. Negotiated Rate	$226.28
Max. Negotiated Rate	$226.28
Rate for Payer: Buckeye Health Medicaid OOS	$226.28
Rate for Payer: Molina Healthcare of OH Medicare	$226.28

OUTPATIENT EAPG 00205: OBSTETRICAL PROCEDURES

Facility OP

$404.15

Service Code	EAPG 00205
Hospital Charge Code	EAPG 00205
Min. Negotiated Rate	$404.15
Max. Negotiated Rate	$404.15
Rate for Payer: Buckeye Health Medicaid OOS	$404.15
Rate for Payer: Molina Healthcare of OH Medicare	$404.15

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