White Rock Medical Center

All Charges

Charge

Type

Setting

Price

DRILL BIT LONG

Facility

$567.50

Hospital Charge Code	145471
Hospital Revenue Code	272
Rate for Payer: Cash Price	$499.40

drill bit press fit

Facility

$2,310.86

Hospital Charge Code	8692518
Hospital Revenue Code	272
Rate for Payer: Cash Price	$2,033.56

drill bit press fit

Facility

$2,310.86

Hospital Charge Code	8692518
Hospital Revenue Code	272
Min. Negotiated Rate	$207.98
Max. Negotiated Rate	$1,502.06
Rate for Payer: Aetna Commercial	$1,270.97
Rate for Payer: Amerigroup CHIP/Medicaid	$207.98
Rate for Payer: BCBS of TX Blue Advantage	$693.26
Rate for Payer: BCBS of TX Blue Essentials	$831.91
Rate for Payer: BCBS of TX PPO	$924.34
Rate for Payer: Cash Price	$2,033.56
Rate for Payer: Multiplan Auto	$1,502.06
Rate for Payer: Multiplan Commercial	$1,502.06
Rate for Payer: Multiplan Workers Comp	$1,502.06
Rate for Payer: Scott and White EPO/PPO	$1,155.43
Rate for Payer: Superior Health Plan EPO	$314.28

DRILL BIT QUICK RELEASE 1/8 32-486265

Facility

$352.76

Hospital Charge Code	144893
Hospital Revenue Code	272
Rate for Payer: Cash Price	$310.43

DRILL BIT QUICK RELEASE 1/8 32-486265

Facility

$352.76

Hospital Charge Code	144893
Hospital Revenue Code	272
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$229.29
Rate for Payer: Aetna Commercial	$194.02
Rate for Payer: Amerigroup CHIP/Medicaid	$31.75
Rate for Payer: BCBS of TX Blue Advantage	$105.83
Rate for Payer: BCBS of TX Blue Essentials	$126.99
Rate for Payer: BCBS of TX PPO	$141.10
Rate for Payer: Cash Price	$310.43
Rate for Payer: Multiplan Auto	$229.29
Rate for Payer: Multiplan Commercial	$229.29
Rate for Payer: Multiplan Workers Comp	$229.29
Rate for Payer: Scott and White EPO/PPO	$176.38
Rate for Payer: Superior Health Plan EPO	$47.98

DRILL BITS 1 -- DHF

Facility

$1,075.98

Hospital Charge Code	80911464
Hospital Revenue Code	272
Min. Negotiated Rate	$96.84
Max. Negotiated Rate	$699.39
Rate for Payer: Aetna Commercial	$591.79
Rate for Payer: Amerigroup CHIP/Medicaid	$96.84
Rate for Payer: BCBS of TX Blue Advantage	$322.79
Rate for Payer: BCBS of TX Blue Essentials	$387.35
Rate for Payer: BCBS of TX PPO	$430.39
Rate for Payer: Cash Price	$946.86
Rate for Payer: Multiplan Auto	$699.39
Rate for Payer: Multiplan Commercial	$699.39
Rate for Payer: Multiplan Workers Comp	$699.39
Rate for Payer: Scott and White EPO/PPO	$537.99
Rate for Payer: Superior Health Plan EPO	$146.33

DRILL BITS 1 -- DHF

Facility

$1,075.98

Hospital Charge Code	80911464
Hospital Revenue Code	272
Rate for Payer: Cash Price	$946.86

DRILL BITS 2

Facility

$928.88

Hospital Charge Code	8394478
Hospital Revenue Code	272
Min. Negotiated Rate	$83.60
Max. Negotiated Rate	$603.77
Rate for Payer: Aetna Commercial	$510.88
Rate for Payer: Amerigroup CHIP/Medicaid	$83.60
Rate for Payer: BCBS of TX Blue Advantage	$278.66
Rate for Payer: BCBS of TX Blue Essentials	$334.40
Rate for Payer: BCBS of TX PPO	$371.55
Rate for Payer: Cash Price	$817.41
Rate for Payer: Multiplan Auto	$603.77
Rate for Payer: Multiplan Commercial	$603.77
Rate for Payer: Multiplan Workers Comp	$603.77
Rate for Payer: Scott and White EPO/PPO	$464.44
Rate for Payer: Superior Health Plan EPO	$126.33

DRILL BITS 2

Facility

$928.88

Hospital Charge Code	8394478
Hospital Revenue Code	272
Rate for Payer: Cash Price	$817.41

DRILL BITS 3 -- DHF

Facility

$724.75

Hospital Charge Code	80911480
Hospital Revenue Code	272
Rate for Payer: Cash Price	$637.78

DRILL BITS 3 -- DHF

Facility

$724.75

Hospital Charge Code	80911480
Hospital Revenue Code	272
Min. Negotiated Rate	$65.23
Max. Negotiated Rate	$471.09
Rate for Payer: Aetna Commercial	$398.61
Rate for Payer: Amerigroup CHIP/Medicaid	$65.23
Rate for Payer: BCBS of TX Blue Advantage	$217.42
Rate for Payer: BCBS of TX Blue Essentials	$260.91
Rate for Payer: BCBS of TX PPO	$289.90
Rate for Payer: Cash Price	$637.78
Rate for Payer: Multiplan Auto	$471.09
Rate for Payer: Multiplan Commercial	$471.09
Rate for Payer: Multiplan Workers Comp	$471.09
Rate for Payer: Scott and White EPO/PPO	$362.38
Rate for Payer: Superior Health Plan EPO	$98.57

DRILL BITS 4

Facility

$908.00

Hospital Charge Code	8420454
Hospital Revenue Code	272
Rate for Payer: Cash Price	$799.04

DRILL BITS 4

Facility

$908.00

Hospital Charge Code	8420454
Hospital Revenue Code	272
Min. Negotiated Rate	$81.72
Max. Negotiated Rate	$590.20
Rate for Payer: Aetna Commercial	$499.40
Rate for Payer: Amerigroup CHIP/Medicaid	$81.72
Rate for Payer: BCBS of TX Blue Advantage	$272.40
Rate for Payer: BCBS of TX Blue Essentials	$326.88
Rate for Payer: BCBS of TX PPO	$363.20
Rate for Payer: Cash Price	$799.04
Rate for Payer: Multiplan Auto	$590.20
Rate for Payer: Multiplan Commercial	$590.20
Rate for Payer: Multiplan Workers Comp	$590.20
Rate for Payer: Scott and White EPO/PPO	$454.00
Rate for Payer: Superior Health Plan EPO	$123.49

DRILL BITS #5

Facility

$227.00

Hospital Charge Code	8492481
Hospital Revenue Code	272
Min. Negotiated Rate	$20.43
Max. Negotiated Rate	$147.55
Rate for Payer: Aetna Commercial	$124.85
Rate for Payer: Amerigroup CHIP/Medicaid	$20.43
Rate for Payer: BCBS of TX Blue Advantage	$68.10
Rate for Payer: BCBS of TX Blue Essentials	$81.72
Rate for Payer: BCBS of TX PPO	$90.80
Rate for Payer: Cash Price	$199.76
Rate for Payer: Multiplan Auto	$147.55
Rate for Payer: Multiplan Commercial	$147.55
Rate for Payer: Multiplan Workers Comp	$147.55
Rate for Payer: Scott and White EPO/PPO	$113.50
Rate for Payer: Superior Health Plan EPO	$30.87

DRILL BITS #5

Facility

$227.00

Hospital Charge Code	8492481
Hospital Revenue Code	272
Rate for Payer: Cash Price	$199.76

DRILL BIT Y-KNOT FLEX

Facility

$304.59

Hospital Charge Code	144848
Hospital Revenue Code	272
Rate for Payer: Cash Price	$268.04

DRILL BIT Y-KNOT FLEX

Facility

$304.59

Hospital Charge Code	144848
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 ZIMMER 3.2MMX30MM

Facility

$335.96

Hospital Charge Code	140617
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 ZIMMER 3.2MMX30MM

Facility

$335.96

Hospital Charge Code	140617
Hospital Revenue Code	272
Rate for Payer: Cash Price	$295.64

DRILL COMP 3.2MM

Facility

$544.80

Hospital Charge Code	144864
Hospital Revenue Code	272
Min. Negotiated Rate	$49.03
Max. Negotiated Rate	$354.12
Rate for Payer: Aetna Commercial	$299.64
Rate for Payer: Amerigroup CHIP/Medicaid	$49.03
Rate for Payer: BCBS of TX Blue Advantage	$163.44
Rate for Payer: BCBS of TX Blue Essentials	$196.13
Rate for Payer: BCBS of TX PPO	$217.92
Rate for Payer: Cash Price	$479.42
Rate for Payer: Multiplan Auto	$354.12
Rate for Payer: Multiplan Commercial	$354.12
Rate for Payer: Multiplan Workers Comp	$354.12
Rate for Payer: Scott and White EPO/PPO	$272.40
Rate for Payer: Superior Health Plan EPO	$74.09

DRILL COMP 3.2MM

Facility

$544.80

Hospital Charge Code	144864
Hospital Revenue Code	272
Rate for Payer: Cash Price	$479.42

DRILL LAG SCREW

Facility

$681.00

Hospital Charge Code	145227
Hospital Revenue Code	272
Min. Negotiated Rate	$61.29
Max. Negotiated Rate	$442.65
Rate for Payer: Aetna Commercial	$374.55
Rate for Payer: Amerigroup CHIP/Medicaid	$61.29
Rate for Payer: BCBS of TX Blue Advantage	$204.30
Rate for Payer: BCBS of TX Blue Essentials	$245.16
Rate for Payer: BCBS of TX PPO	$272.40
Rate for Payer: Cash Price	$599.28
Rate for Payer: Multiplan Auto	$442.65
Rate for Payer: Multiplan Commercial	$442.65
Rate for Payer: Multiplan Workers Comp	$442.65
Rate for Payer: Scott and White EPO/PPO	$340.50
Rate for Payer: Superior Health Plan EPO	$92.62

DRILL LAG SCREW

Facility

$681.00

Hospital Charge Code	145227
Hospital Revenue Code	272
Rate for Payer: Cash Price	$599.28

DRILL LAG SCRW

Facility

$681.00

Hospital Charge Code	145481
Hospital Revenue Code	272
Rate for Payer: Cash Price	$599.28

DRILL LAG SCRW

Facility

$681.00

Hospital Charge Code	145481
Hospital Revenue Code	272
Min. Negotiated Rate	$61.29
Max. Negotiated Rate	$442.65
Rate for Payer: Aetna Commercial	$374.55
Rate for Payer: Amerigroup CHIP/Medicaid	$61.29
Rate for Payer: BCBS of TX Blue Advantage	$204.30
Rate for Payer: BCBS of TX Blue Essentials	$245.16
Rate for Payer: BCBS of TX PPO	$272.40
Rate for Payer: Cash Price	$599.28
Rate for Payer: Multiplan Auto	$442.65
Rate for Payer: Multiplan Commercial	$442.65
Rate for Payer: Multiplan Workers Comp	$442.65
Rate for Payer: Scott and White EPO/PPO	$340.50
Rate for Payer: Superior Health Plan EPO	$92.62

Know your out-of-pocket cost for care.

All Charges