White Rock Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT 04.2 X 300MM

Facility

$1,579.92

Hospital Charge Code	145342
Hospital Revenue Code	272
Rate for Payer: Cash Price	$1,390.33

DRILL BIT 04.2 X 300MM

Facility

$1,579.92

Hospital Charge Code	145342
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$1,026.95
Rate for Payer: Aetna Commercial	$868.96
Rate for Payer: Amerigroup CHIP/Medicaid	$142.19
Rate for Payer: BCBS of TX Blue Advantage	$473.98
Rate for Payer: BCBS of TX Blue Essentials	$568.77
Rate for Payer: BCBS of TX PPO	$631.97
Rate for Payer: Cash Price	$1,390.33
Rate for Payer: Multiplan Auto	$1,026.95
Rate for Payer: Multiplan Commercial	$1,026.95
Rate for Payer: Multiplan Workers Comp	$1,026.95
Rate for Payer: Scott and White EPO/PPO	$789.96
Rate for Payer: Superior Health Plan EPO	$214.87

DRILL BIT 2.0MM

Facility

$1,702.50

Hospital Charge Code	145137
Hospital Revenue Code	272
Min. Negotiated Rate	$153.22
Max. Negotiated Rate	$1,106.62
Rate for Payer: Aetna Commercial	$936.38
Rate for Payer: Amerigroup CHIP/Medicaid	$153.22
Rate for Payer: BCBS of TX Blue Advantage	$510.75
Rate for Payer: BCBS of TX Blue Essentials	$612.90
Rate for Payer: BCBS of TX PPO	$681.00
Rate for Payer: Cash Price	$1,498.20
Rate for Payer: Multiplan Auto	$1,106.62
Rate for Payer: Multiplan Commercial	$1,106.62
Rate for Payer: Multiplan Workers Comp	$1,106.62
Rate for Payer: Scott and White EPO/PPO	$851.25
Rate for Payer: Superior Health Plan EPO	$231.54

DRILL BIT 2.0MM

Facility

$1,702.50

Hospital Charge Code	145137
Hospital Revenue Code	272
Rate for Payer: Cash Price	$1,498.20

DRILL BIT 2.5MM

Facility

$358.66

Hospital Charge Code	145272
Hospital Revenue Code	272
Rate for Payer: Cash Price	$315.62

DRILL BIT 2.5MM

Facility

$358.66

Hospital Charge Code	145272
Hospital Revenue Code	272
Min. Negotiated Rate	$32.28
Max. Negotiated Rate	$233.13
Rate for Payer: Aetna Commercial	$197.26
Rate for Payer: Amerigroup CHIP/Medicaid	$32.28
Rate for Payer: BCBS of TX Blue Advantage	$107.60
Rate for Payer: BCBS of TX Blue Essentials	$129.12
Rate for Payer: BCBS of TX PPO	$143.46
Rate for Payer: Cash Price	$315.62
Rate for Payer: Multiplan Auto	$233.13
Rate for Payer: Multiplan Commercial	$233.13
Rate for Payer: Multiplan Workers Comp	$233.13
Rate for Payer: Scott and White EPO/PPO	$179.33
Rate for Payer: Superior Health Plan EPO	$48.78

DRILL BIT 3.2MM

Facility

$1,510.19

Hospital Charge Code	114050
Hospital Revenue Code	272
Min. Negotiated Rate	$135.92
Max. Negotiated Rate	$981.62
Rate for Payer: Aetna Commercial	$830.60
Rate for Payer: Amerigroup CHIP/Medicaid	$135.92
Rate for Payer: BCBS of TX Blue Advantage	$453.06
Rate for Payer: BCBS of TX Blue Essentials	$543.67
Rate for Payer: BCBS of TX PPO	$604.08
Rate for Payer: Cash Price	$1,328.97
Rate for Payer: Multiplan Auto	$981.62
Rate for Payer: Multiplan Commercial	$981.62
Rate for Payer: Multiplan Workers Comp	$981.62
Rate for Payer: Scott and White EPO/PPO	$755.10
Rate for Payer: Superior Health Plan EPO	$205.39

DRILL BIT 3.2MM

Facility

$1,510.19

Hospital Charge Code	114050
Hospital Revenue Code	272
Rate for Payer: Cash Price	$1,328.97

DRILL BIT 3.2MM 31323230 ZIMMER

Facility

$335.96

Hospital Charge Code	114118
Hospital Revenue Code	272
Min. Negotiated Rate	$30.24
Max. Negotiated Rate	$218.37
Rate for Payer: Aetna Commercial	$184.78
Rate for Payer: Amerigroup CHIP/Medicaid	$30.24
Rate for Payer: BCBS of TX Blue Advantage	$100.79
Rate for Payer: BCBS of TX Blue Essentials	$120.95
Rate for Payer: BCBS of TX PPO	$134.38
Rate for Payer: Cash Price	$295.64
Rate for Payer: Multiplan Auto	$218.37
Rate for Payer: Multiplan Commercial	$218.37
Rate for Payer: Multiplan Workers Comp	$218.37
Rate for Payer: Scott and White EPO/PPO	$167.98
Rate for Payer: Superior Health Plan EPO	$45.69

DRILL BIT 3.2MM 31323230 ZIMMER

Facility

$335.96

Hospital Charge Code	114118
Hospital Revenue Code	272
Rate for Payer: Cash Price	$295.64

DRILL BIT 4.2 X 180

Facility

$1,579.92

Hospital Charge Code	145367
Hospital Revenue Code	272
Rate for Payer: Cash Price	$1,390.33

DRILL BIT 4.2 X 180

Facility

$1,579.92

Hospital Charge Code	145367
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$1,026.95
Rate for Payer: Aetna Commercial	$868.96
Rate for Payer: Amerigroup CHIP/Medicaid	$142.19
Rate for Payer: BCBS of TX Blue Advantage	$473.98
Rate for Payer: BCBS of TX Blue Essentials	$568.77
Rate for Payer: BCBS of TX PPO	$631.97
Rate for Payer: Cash Price	$1,390.33
Rate for Payer: Multiplan Auto	$1,026.95
Rate for Payer: Multiplan Commercial	$1,026.95
Rate for Payer: Multiplan Workers Comp	$1,026.95
Rate for Payer: Scott and White EPO/PPO	$789.96
Rate for Payer: Superior Health Plan EPO	$214.87

DRILL BIT 4.3MM

Facility

$1,510.19

Hospital Charge Code	114051
Hospital Revenue Code	272
Rate for Payer: Cash Price	$1,328.97

DRILL BIT 4.3MM

Facility

$1,510.19

Hospital Charge Code	114051
Hospital Revenue Code	272
Min. Negotiated Rate	$135.92
Max. Negotiated Rate	$981.62
Rate for Payer: Aetna Commercial	$830.60
Rate for Payer: Amerigroup CHIP/Medicaid	$135.92
Rate for Payer: BCBS of TX Blue Advantage	$453.06
Rate for Payer: BCBS of TX Blue Essentials	$543.67
Rate for Payer: BCBS of TX PPO	$604.08
Rate for Payer: Cash Price	$1,328.97
Rate for Payer: Multiplan Auto	$981.62
Rate for Payer: Multiplan Commercial	$981.62
Rate for Payer: Multiplan Workers Comp	$981.62
Rate for Payer: Scott and White EPO/PPO	$755.10
Rate for Payer: Superior Health Plan EPO	$205.39

drill bit 5.2x300mm

Facility

$1,579.92

Hospital Charge Code	8720615
Hospital Revenue Code	272
Rate for Payer: Cash Price	$1,390.33

drill bit 5.2x300mm

Facility

$1,579.92

Hospital Charge Code	8720615
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$1,026.95
Rate for Payer: Aetna Commercial	$868.96
Rate for Payer: Amerigroup CHIP/Medicaid	$142.19
Rate for Payer: BCBS of TX Blue Advantage	$473.98
Rate for Payer: BCBS of TX Blue Essentials	$568.77
Rate for Payer: BCBS of TX PPO	$631.97
Rate for Payer: Cash Price	$1,390.33
Rate for Payer: Multiplan Auto	$1,026.95
Rate for Payer: Multiplan Commercial	$1,026.95
Rate for Payer: Multiplan Workers Comp	$1,026.95
Rate for Payer: Scott and White EPO/PPO	$789.96
Rate for Payer: Superior Health Plan EPO	$214.87

DRILL BIT CANNL -- DHF

Facility

$2,653.56

Hospital Charge Code	81740508
Hospital Revenue Code	272
Rate for Payer: Cash Price	$2,335.13

DRILL BIT CANNL -- DHF

Facility

$2,653.56

Hospital Charge Code	81740508
Hospital Revenue Code	272
Min. Negotiated Rate	$238.82
Max. Negotiated Rate	$1,724.81
Rate for Payer: Aetna Commercial	$1,459.46
Rate for Payer: Amerigroup CHIP/Medicaid	$238.82
Rate for Payer: BCBS of TX Blue Advantage	$796.07
Rate for Payer: BCBS of TX Blue Essentials	$955.28
Rate for Payer: BCBS of TX PPO	$1,061.42
Rate for Payer: Cash Price	$2,335.13
Rate for Payer: Multiplan Auto	$1,724.81
Rate for Payer: Multiplan Commercial	$1,724.81
Rate for Payer: Multiplan Workers Comp	$1,724.81
Rate for Payer: Scott and White EPO/PPO	$1,326.78
Rate for Payer: Superior Health Plan EPO	$360.88

DRILL BIT FLEX Y-KNOT Y18D

Facility

$304.59

Hospital Charge Code	145090
Hospital Revenue Code	272
Rate for Payer: Cash Price	$268.04

DRILL BIT FLEX Y-KNOT Y18D

Facility

$304.59

Hospital Charge Code	145090
Hospital Revenue Code	272
Min. Negotiated Rate	$27.41
Max. Negotiated Rate	$197.98
Rate for Payer: Aetna Commercial	$167.52
Rate for Payer: Amerigroup CHIP/Medicaid	$27.41
Rate for Payer: BCBS of TX Blue Advantage	$91.38
Rate for Payer: BCBS of TX Blue Essentials	$109.65
Rate for Payer: BCBS of TX PPO	$121.84
Rate for Payer: Cash Price	$268.04
Rate for Payer: Multiplan Auto	$197.98
Rate for Payer: Multiplan Commercial	$197.98
Rate for Payer: Multiplan Workers Comp	$197.98
Rate for Payer: Scott and White EPO/PPO	$152.30
Rate for Payer: Superior Health Plan EPO	$41.42

drill bit gamma 4.2x300mm ao small

Facility

$1,129.64

Hospital Charge Code	8660703
Hospital Revenue Code	272
Min. Negotiated Rate	$101.67
Max. Negotiated Rate	$734.27
Rate for Payer: Aetna Commercial	$621.30
Rate for Payer: Amerigroup CHIP/Medicaid	$101.67
Rate for Payer: BCBS of TX Blue Advantage	$338.89
Rate for Payer: BCBS of TX Blue Essentials	$406.67
Rate for Payer: BCBS of TX PPO	$451.86
Rate for Payer: Cash Price	$994.08
Rate for Payer: Multiplan Auto	$734.27
Rate for Payer: Multiplan Commercial	$734.27
Rate for Payer: Multiplan Workers Comp	$734.27
Rate for Payer: Scott and White EPO/PPO	$564.82
Rate for Payer: Superior Health Plan EPO	$153.63

drill bit gamma 4.2x300mm ao small

Facility

$1,129.64

Hospital Charge Code	8660703
Hospital Revenue Code	272
Rate for Payer: Cash Price	$994.08

drill bit lag screw stopper

Facility

$3,519.41

Hospital Charge Code	8720616
Hospital Revenue Code	272
Min. Negotiated Rate	$316.75
Max. Negotiated Rate	$2,287.62
Rate for Payer: Aetna Commercial	$1,935.68
Rate for Payer: Amerigroup CHIP/Medicaid	$316.75
Rate for Payer: BCBS of TX Blue Advantage	$1,055.82
Rate for Payer: BCBS of TX Blue Essentials	$1,266.99
Rate for Payer: BCBS of TX PPO	$1,407.76
Rate for Payer: Cash Price	$3,097.08
Rate for Payer: Multiplan Auto	$2,287.62
Rate for Payer: Multiplan Commercial	$2,287.62
Rate for Payer: Multiplan Workers Comp	$2,287.62
Rate for Payer: Scott and White EPO/PPO	$1,759.70
Rate for Payer: Superior Health Plan EPO	$478.64

drill bit lag screw stopper

Facility

$3,519.41

Hospital Charge Code	8720616
Hospital Revenue Code	272
Rate for Payer: Cash Price	$3,097.08

DRILL BIT LONG

Facility

$567.50

Hospital Charge Code	145471
Hospital Revenue Code	272
Min. Negotiated Rate	$51.08
Max. Negotiated Rate	$368.88
Rate for Payer: Aetna Commercial	$312.12
Rate for Payer: Amerigroup CHIP/Medicaid	$51.08
Rate for Payer: BCBS of TX Blue Advantage	$170.25
Rate for Payer: BCBS of TX Blue Essentials	$204.30
Rate for Payer: BCBS of TX PPO	$227.00
Rate for Payer: Cash Price	$499.40
Rate for Payer: Multiplan Auto	$368.88
Rate for Payer: Multiplan Commercial	$368.88
Rate for Payer: Multiplan Workers Comp	$368.88
Rate for Payer: Scott and White EPO/PPO	$283.75
Rate for Payer: Superior Health Plan EPO	$77.18

Know your out-of-pocket cost for care.

All Charges