White Rock Medical Center

All Charges

Charge

Type

Setting

Price

EXFX NUT SPRING LOAD -- DHF

Facility

$17.48

Hospital Charge Code	81321531
Hospital Revenue Code	272
Rate for Payer: Cash Price	$15.38

EXFX OLIVE WIRE

Facility

$789.96

Hospital Charge Code	122772
Hospital Revenue Code	272
Min. Negotiated Rate	$71.10
Max. Negotiated Rate	$513.47
Rate for Payer: Aetna Commercial	$434.48
Rate for Payer: Amerigroup CHIP/Medicaid	$71.10
Rate for Payer: BCBS of TX Blue Advantage	$236.99
Rate for Payer: BCBS of TX Blue Essentials	$284.39
Rate for Payer: BCBS of TX PPO	$315.98
Rate for Payer: Cash Price	$695.16
Rate for Payer: Multiplan Auto	$513.47
Rate for Payer: Multiplan Commercial	$513.47
Rate for Payer: Multiplan Workers Comp	$513.47
Rate for Payer: Scott and White EPO/PPO	$394.98
Rate for Payer: Superior Health Plan EPO	$107.43

EXFX OLIVE WIRE

Facility

$789.96

Hospital Charge Code	122772
Hospital Revenue Code	272
Rate for Payer: Cash Price	$695.16

EXFX OLIVE WIRE 1.8MM

Facility

$489.09

Hospital Charge Code	126424
Hospital Revenue Code	272
Min. Negotiated Rate	$44.02
Max. Negotiated Rate	$317.91
Rate for Payer: Aetna Commercial	$269.00
Rate for Payer: Amerigroup CHIP/Medicaid	$44.02
Rate for Payer: BCBS of TX Blue Advantage	$146.73
Rate for Payer: BCBS of TX Blue Essentials	$176.07
Rate for Payer: BCBS of TX PPO	$195.64
Rate for Payer: Cash Price	$430.40
Rate for Payer: Multiplan Auto	$317.91
Rate for Payer: Multiplan Commercial	$317.91
Rate for Payer: Multiplan Workers Comp	$317.91
Rate for Payer: Scott and White EPO/PPO	$244.54
Rate for Payer: Superior Health Plan EPO	$66.52

EXFX OLIVE WIRE 1.8MM

Facility

$489.09

Hospital Charge Code	126424
Hospital Revenue Code	272
Rate for Payer: Cash Price	$430.40

exfx pin 2.0x20m-stryker

Facility

$312.35

Hospital Charge Code	8628564
Hospital Revenue Code	272
Min. Negotiated Rate	$28.11
Max. Negotiated Rate	$203.03
Rate for Payer: Aetna Commercial	$171.79
Rate for Payer: Amerigroup CHIP/Medicaid	$28.11
Rate for Payer: BCBS of TX Blue Advantage	$93.70
Rate for Payer: BCBS of TX Blue Essentials	$112.45
Rate for Payer: BCBS of TX PPO	$124.94
Rate for Payer: Cash Price	$274.87
Rate for Payer: Multiplan Auto	$203.03
Rate for Payer: Multiplan Commercial	$203.03
Rate for Payer: Multiplan Workers Comp	$203.03
Rate for Payer: Scott and White EPO/PPO	$156.18
Rate for Payer: Superior Health Plan EPO	$42.48

exfx pin 2.0x20m-stryker

Facility

$312.35

Hospital Charge Code	8628564
Hospital Revenue Code	272
Rate for Payer: Cash Price	$274.87

EXFX PIN CLAMP

Facility

$3,791.53

Hospital Charge Code	8470494
Hospital Revenue Code	272
Min. Negotiated Rate	$341.24
Max. Negotiated Rate	$2,464.49
Rate for Payer: Aetna Commercial	$2,085.34
Rate for Payer: Amerigroup CHIP/Medicaid	$341.24
Rate for Payer: BCBS of TX Blue Advantage	$1,137.46
Rate for Payer: BCBS of TX Blue Essentials	$1,364.95
Rate for Payer: BCBS of TX PPO	$1,516.61
Rate for Payer: Cash Price	$3,336.55
Rate for Payer: Multiplan Auto	$2,464.49
Rate for Payer: Multiplan Commercial	$2,464.49
Rate for Payer: Multiplan Workers Comp	$2,464.49
Rate for Payer: Scott and White EPO/PPO	$1,895.76
Rate for Payer: Superior Health Plan EPO	$515.65

EXFX PIN CLAMP

Facility

$3,791.53

Hospital Charge Code	8470494
Hospital Revenue Code	272
Rate for Payer: Cash Price	$3,336.55

EXFX PIN HALF APEX

Facility

$961.84

Hospital Charge Code	130857
Hospital Revenue Code	272
Min. Negotiated Rate	$86.57
Max. Negotiated Rate	$625.20
Rate for Payer: Aetna Commercial	$529.01
Rate for Payer: Amerigroup CHIP/Medicaid	$86.57
Rate for Payer: BCBS of TX Blue Advantage	$288.55
Rate for Payer: BCBS of TX Blue Essentials	$346.26
Rate for Payer: BCBS of TX PPO	$384.74
Rate for Payer: Cash Price	$846.42
Rate for Payer: Multiplan Auto	$625.20
Rate for Payer: Multiplan Commercial	$625.20
Rate for Payer: Multiplan Workers Comp	$625.20
Rate for Payer: Scott and White EPO/PPO	$480.92
Rate for Payer: Superior Health Plan EPO	$130.81

EXFX PIN HALF APEX

Facility

$961.84

Hospital Charge Code	130857
Hospital Revenue Code	272
Rate for Payer: Cash Price	$846.42

EXFX PIN TO ROD CLAMP

Facility

$3,766.02

Hospital Charge Code	141033
Hospital Revenue Code	272
Rate for Payer: Cash Price	$3,314.10

EXFX PIN TO ROD CLAMP

Facility

$3,766.02

Hospital Charge Code	141033
Hospital Revenue Code	272
Min. Negotiated Rate	$338.94
Max. Negotiated Rate	$2,447.91
Rate for Payer: Aetna Commercial	$2,071.31
Rate for Payer: Amerigroup CHIP/Medicaid	$338.94
Rate for Payer: BCBS of TX Blue Advantage	$1,129.81
Rate for Payer: BCBS of TX Blue Essentials	$1,355.77
Rate for Payer: BCBS of TX PPO	$1,506.41
Rate for Payer: Cash Price	$3,314.10
Rate for Payer: Multiplan Auto	$2,447.91
Rate for Payer: Multiplan Commercial	$2,447.91
Rate for Payer: Multiplan Workers Comp	$2,447.91
Rate for Payer: Scott and White EPO/PPO	$1,883.01
Rate for Payer: Superior Health Plan EPO	$512.18

EXFX PIN TRANSFIX

Facility

$532.08

Hospital Charge Code	8470495
Hospital Revenue Code	272
Rate for Payer: Cash Price	$468.23

EXFX PIN TRANSFIX

Facility

$532.08

Hospital Charge Code	8470495
Hospital Revenue Code	272
Min. Negotiated Rate	$47.89
Max. Negotiated Rate	$345.85
Rate for Payer: Aetna Commercial	$292.64
Rate for Payer: Amerigroup CHIP/Medicaid	$47.89
Rate for Payer: BCBS of TX Blue Advantage	$159.62
Rate for Payer: BCBS of TX Blue Essentials	$191.55
Rate for Payer: BCBS of TX PPO	$212.83
Rate for Payer: Cash Price	$468.23
Rate for Payer: Multiplan Auto	$345.85
Rate for Payer: Multiplan Commercial	$345.85
Rate for Payer: Multiplan Workers Comp	$345.85
Rate for Payer: Scott and White EPO/PPO	$266.04
Rate for Payer: Superior Health Plan EPO	$72.36

EXFX PLATE II -- DHF

Facility

$2,642.28

Hospital Charge Code	81321572
Hospital Revenue Code	272
Rate for Payer: Cash Price	$2,325.21

EXFX PLATE II -- DHF

Facility

$2,642.28

Hospital Charge Code	81321572
Hospital Revenue Code	272
Min. Negotiated Rate	$237.81
Max. Negotiated Rate	$1,717.48
Rate for Payer: Aetna Commercial	$1,453.25
Rate for Payer: Amerigroup CHIP/Medicaid	$237.81
Rate for Payer: BCBS of TX Blue Advantage	$792.68
Rate for Payer: BCBS of TX Blue Essentials	$951.22
Rate for Payer: BCBS of TX PPO	$1,056.91
Rate for Payer: Cash Price	$2,325.21
Rate for Payer: Multiplan Auto	$1,717.48
Rate for Payer: Multiplan Commercial	$1,717.48
Rate for Payer: Multiplan Workers Comp	$1,717.48
Rate for Payer: Scott and White EPO/PPO	$1,321.14
Rate for Payer: Superior Health Plan EPO	$359.35

EXFX POST 1 HOLE

Facility

$668.06

Hospital Charge Code	138308
Hospital Revenue Code	272
Min. Negotiated Rate	$60.13
Max. Negotiated Rate	$434.24
Rate for Payer: Aetna Commercial	$367.43
Rate for Payer: Amerigroup CHIP/Medicaid	$60.13
Rate for Payer: BCBS of TX Blue Advantage	$200.42
Rate for Payer: BCBS of TX Blue Essentials	$240.50
Rate for Payer: BCBS of TX PPO	$267.22
Rate for Payer: Cash Price	$587.89
Rate for Payer: Multiplan Auto	$434.24
Rate for Payer: Multiplan Commercial	$434.24
Rate for Payer: Multiplan Workers Comp	$434.24
Rate for Payer: Scott and White EPO/PPO	$334.03
Rate for Payer: Superior Health Plan EPO	$90.86

EXFX POST 1 HOLE

Facility

$668.06

Hospital Charge Code	138308
Hospital Revenue Code	272
Rate for Payer: Cash Price	$587.89

EXFX POST 2 HOLE

Facility

$1,195.56

Hospital Charge Code	130820
Hospital Revenue Code	272
Rate for Payer: Cash Price	$1,052.09

EXFX POST 2 HOLE

Facility

$1,195.56

Hospital Charge Code	130820
Hospital Revenue Code	272
Min. Negotiated Rate	$107.60
Max. Negotiated Rate	$777.11
Rate for Payer: Aetna Commercial	$657.56
Rate for Payer: Amerigroup CHIP/Medicaid	$107.60
Rate for Payer: BCBS of TX Blue Advantage	$358.67
Rate for Payer: BCBS of TX Blue Essentials	$430.40
Rate for Payer: BCBS of TX PPO	$478.22
Rate for Payer: Cash Price	$1,052.09
Rate for Payer: Multiplan Auto	$777.11
Rate for Payer: Multiplan Commercial	$777.11
Rate for Payer: Multiplan Workers Comp	$777.11
Rate for Payer: Scott and White EPO/PPO	$597.78
Rate for Payer: Superior Health Plan EPO	$162.60

EXFX POST HF -- DHF

Facility

$528.91

Hospital Charge Code	81321622
Hospital Revenue Code	272
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$343.79
Rate for Payer: Aetna Commercial	$290.90
Rate for Payer: Amerigroup CHIP/Medicaid	$47.60
Rate for Payer: BCBS of TX Blue Advantage	$158.67
Rate for Payer: BCBS of TX Blue Essentials	$190.41
Rate for Payer: BCBS of TX PPO	$211.56
Rate for Payer: Cash Price	$465.44
Rate for Payer: Multiplan Auto	$343.79
Rate for Payer: Multiplan Commercial	$343.79
Rate for Payer: Multiplan Workers Comp	$343.79
Rate for Payer: Scott and White EPO/PPO	$264.46
Rate for Payer: Superior Health Plan EPO	$71.93

EXFX POST HF -- DHF

Facility

$528.91

Hospital Charge Code	81321622
Hospital Revenue Code	272
Rate for Payer: Cash Price	$465.44

EXFX RD LG -- DHF

Facility

$207.89

Hospital Charge Code	81321655
Hospital Revenue Code	272
Rate for Payer: Cash Price	$182.94

EXFX RD LG -- DHF

Facility

$207.89

Hospital Charge Code	81321655
Hospital Revenue Code	272
Min. Negotiated Rate	$18.71
Max. Negotiated Rate	$135.13
Rate for Payer: Aetna Commercial	$114.34
Rate for Payer: Amerigroup CHIP/Medicaid	$18.71
Rate for Payer: BCBS of TX Blue Advantage	$62.37
Rate for Payer: BCBS of TX Blue Essentials	$74.84
Rate for Payer: BCBS of TX PPO	$83.16
Rate for Payer: Cash Price	$182.94
Rate for Payer: Multiplan Auto	$135.13
Rate for Payer: Multiplan Commercial	$135.13
Rate for Payer: Multiplan Workers Comp	$135.13
Rate for Payer: Scott and White EPO/PPO	$103.94
Rate for Payer: Superior Health Plan EPO	$28.27

Know your out-of-pocket cost for care.

All Charges