White Rock Medical Center

All Charges

Charge

Type

Setting

Price

DRILL CANNULATED STEP 6MM/9MM

Facility

$6,419.56

Hospital Charge Code	146585
Hospital Revenue Code	272
Min. Negotiated Rate	$577.76
Max. Negotiated Rate	$4,622.08
Rate for Payer: Amerigroup CHIP/Medicaid	$577.76
Rate for Payer: BCBS of TX Blue Advantage	$1,925.87
Rate for Payer: BCBS of TX Blue Essentials	$2,311.04
Rate for Payer: BCBS of TX PPO	$2,567.82
Rate for Payer: Cash Price	$4,365.30
Rate for Payer: Cigna Medicaid	$4,622.08
Rate for Payer: Molina CHIP/Medicaid	$4,622.08
Rate for Payer: Multiplan Auto	$4,172.71
Rate for Payer: Multiplan Commercial	$4,172.71
Rate for Payer: Multiplan Workers Comp	$4,172.71
Rate for Payer: Parkland Medicaid	$4,622.08
Rate for Payer: Scott and White EPO/PPO	$3,209.78
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4,622.08
Rate for Payer: Superior Health Plan EPO	$873.06

DRILL CANNULATED TAPERED 10MM

Facility

$5,656.84

Hospital Charge Code	146584
Hospital Revenue Code	272
Min. Negotiated Rate	$509.12
Max. Negotiated Rate	$4,072.92
Rate for Payer: Amerigroup CHIP/Medicaid	$509.12
Rate for Payer: BCBS of TX Blue Advantage	$1,697.05
Rate for Payer: BCBS of TX Blue Essentials	$2,036.46
Rate for Payer: BCBS of TX PPO	$2,262.74
Rate for Payer: Cash Price	$3,846.65
Rate for Payer: Cigna Medicaid	$4,072.92
Rate for Payer: Molina CHIP/Medicaid	$4,072.92
Rate for Payer: Multiplan Auto	$3,676.95
Rate for Payer: Multiplan Commercial	$3,676.95
Rate for Payer: Multiplan Workers Comp	$3,676.95
Rate for Payer: Parkland Medicaid	$4,072.92
Rate for Payer: Scott and White EPO/PPO	$2,828.42
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4,072.92
Rate for Payer: Superior Health Plan EPO	$769.33

DRILL CANNULATED TAPERED 10MM

Facility

$5,656.84

Hospital Charge Code	146584
Hospital Revenue Code	272
Rate for Payer: Cash Price	$3,846.65

DRILL COMP RVS 2.7MM DIA

Facility

$703.70

Hospital Charge Code	144863
Hospital Revenue Code	272
Min. Negotiated Rate	$63.33
Max. Negotiated Rate	$506.66
Rate for Payer: Amerigroup CHIP/Medicaid	$63.33
Rate for Payer: BCBS of TX Blue Advantage	$211.11
Rate for Payer: BCBS of TX Blue Essentials	$253.33
Rate for Payer: BCBS of TX PPO	$281.48
Rate for Payer: Cash Price	$478.52
Rate for Payer: Cigna Medicaid	$506.66
Rate for Payer: Molina CHIP/Medicaid	$506.66
Rate for Payer: Multiplan Auto	$457.40
Rate for Payer: Multiplan Commercial	$457.40
Rate for Payer: Multiplan Workers Comp	$457.40
Rate for Payer: Parkland Medicaid	$506.66
Rate for Payer: Scott and White EPO/PPO	$351.85
Rate for Payer: Superior Health Plan CHIP/Medicaid	$506.66
Rate for Payer: Superior Health Plan EPO	$95.70

DRILL COMP RVS 2.7MM DIA

Facility

$703.70

Hospital Charge Code	144863
Hospital Revenue Code	272
Rate for Payer: Cash Price	$478.52

DRILL COMP RVS 3.2MM

Facility

$544.80

Hospital Charge Code	144864
Hospital Revenue Code	272
Rate for Payer: Cash Price	$370.46

DRILL COMP RVS 3.2MM

Facility

$544.80

Hospital Charge Code	144864
Hospital Revenue Code	272
Min. Negotiated Rate	$49.03
Max. Negotiated Rate	$392.26
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	$370.46
Rate for Payer: Cigna Medicaid	$392.26
Rate for Payer: Molina CHIP/Medicaid	$392.26
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: Parkland Medicaid	$392.26
Rate for Payer: Scott and White EPO/PPO	$272.40
Rate for Payer: Superior Health Plan CHIP/Medicaid	$392.26
Rate for Payer: Superior Health Plan EPO	$74.09

DRILL FLEXIBLE CANNULATED 16MM

Facility

$9,570.32

Hospital Charge Code	146581
Hospital Revenue Code	272
Rate for Payer: Cash Price	$6,507.82

DRILL FLEXIBLE CANNULATED 16MM

Facility

$9,570.32

Hospital Charge Code	146581
Hospital Revenue Code	272
Min. Negotiated Rate	$861.33
Max. Negotiated Rate	$6,890.63
Rate for Payer: Amerigroup CHIP/Medicaid	$861.33
Rate for Payer: BCBS of TX Blue Advantage	$2,871.10
Rate for Payer: BCBS of TX Blue Essentials	$3,445.32
Rate for Payer: BCBS of TX PPO	$3,828.13
Rate for Payer: Cash Price	$6,507.82
Rate for Payer: Cigna Medicaid	$6,890.63
Rate for Payer: Molina CHIP/Medicaid	$6,890.63
Rate for Payer: Multiplan Auto	$6,220.71
Rate for Payer: Multiplan Commercial	$6,220.71
Rate for Payer: Multiplan Workers Comp	$6,220.71
Rate for Payer: Parkland Medicaid	$6,890.63
Rate for Payer: Scott and White EPO/PPO	$4,785.16
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6,890.63
Rate for Payer: Superior Health Plan EPO	$1,301.56

DRILL LAG SCREW

Facility

$681.00

Hospital Charge Code	145227
Hospital Revenue Code	272
Rate for Payer: Cash Price	$463.08

DRILL LAG SCREW

Facility

$681.00

Hospital Charge Code	145227
Hospital Revenue Code	272
Min. Negotiated Rate	$61.29
Max. Negotiated Rate	$490.32
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	$463.08
Rate for Payer: Cigna Medicaid	$490.32
Rate for Payer: Molina CHIP/Medicaid	$490.32
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: Parkland Medicaid	$490.32
Rate for Payer: Scott and White EPO/PPO	$340.50
Rate for Payer: Superior Health Plan CHIP/Medicaid	$490.32
Rate for Payer: Superior Health Plan EPO	$92.62

DRILL LAG SCRW

Facility

$681.00

Hospital Charge Code	145481
Hospital Revenue Code	272
Min. Negotiated Rate	$61.29
Max. Negotiated Rate	$490.32
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	$463.08
Rate for Payer: Cigna Medicaid	$490.32
Rate for Payer: Molina CHIP/Medicaid	$490.32
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: Parkland Medicaid	$490.32
Rate for Payer: Scott and White EPO/PPO	$340.50
Rate for Payer: Superior Health Plan CHIP/Medicaid	$490.32
Rate for Payer: Superior Health Plan EPO	$92.62

DRILL LAG SCRW

Facility

$681.00

Hospital Charge Code	145481
Hospital Revenue Code	272
Rate for Payer: Cash Price	$463.08

drill lag stepped gamma3 15.5x495mm

Facility

$10,058.91

Hospital Charge Code	8660702
Hospital Revenue Code	272
Rate for Payer: Cash Price	$6,840.06

drill lag stepped gamma3 15.5x495mm

Facility

$10,058.91

Hospital Charge Code	8660702
Hospital Revenue Code	272
Min. Negotiated Rate	$905.30
Max. Negotiated Rate	$7,242.42
Rate for Payer: Amerigroup CHIP/Medicaid	$905.30
Rate for Payer: BCBS of TX Blue Advantage	$3,017.67
Rate for Payer: BCBS of TX Blue Essentials	$3,621.21
Rate for Payer: BCBS of TX PPO	$4,023.56
Rate for Payer: Cash Price	$6,840.06
Rate for Payer: Cigna Medicaid	$7,242.42
Rate for Payer: Molina CHIP/Medicaid	$7,242.42
Rate for Payer: Multiplan Auto	$6,538.29
Rate for Payer: Multiplan Commercial	$6,538.29
Rate for Payer: Multiplan Workers Comp	$6,538.29
Rate for Payer: Parkland Medicaid	$7,242.42
Rate for Payer: Scott and White EPO/PPO	$5,029.45
Rate for Payer: Superior Health Plan CHIP/Medicaid	$7,242.42
Rate for Payer: Superior Health Plan EPO	$1,368.01

DRILL LONG DISP -- DHF

Facility

$7,003.40

Hospital Charge Code	81315673
Hospital Revenue Code	272
Min. Negotiated Rate	$630.31
Max. Negotiated Rate	$5,042.45
Rate for Payer: Amerigroup CHIP/Medicaid	$630.31
Rate for Payer: BCBS of TX Blue Advantage	$2,101.02
Rate for Payer: BCBS of TX Blue Essentials	$2,521.22
Rate for Payer: BCBS of TX PPO	$2,801.36
Rate for Payer: Cash Price	$4,762.31
Rate for Payer: Cigna Medicaid	$5,042.45
Rate for Payer: Molina CHIP/Medicaid	$5,042.45
Rate for Payer: Multiplan Auto	$4,552.21
Rate for Payer: Multiplan Commercial	$4,552.21
Rate for Payer: Multiplan Workers Comp	$4,552.21
Rate for Payer: Parkland Medicaid	$5,042.45
Rate for Payer: Scott and White EPO/PPO	$3,501.70
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5,042.45
Rate for Payer: Superior Health Plan EPO	$952.46

DRILL LONG DISP -- DHF

Facility

$7,003.40

Hospital Charge Code	81315673
Hospital Revenue Code	272
Rate for Payer: Cash Price	$4,762.31

DRILL QUICK RELEASE 1/8 STERILE 2PK

Facility

$352.76

Hospital Charge Code	144893
Hospital Revenue Code	272
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$253.99
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	$239.88
Rate for Payer: Cigna Medicaid	$253.99
Rate for Payer: Molina CHIP/Medicaid	$253.99
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: Parkland Medicaid	$253.99
Rate for Payer: Scott and White EPO/PPO	$176.38
Rate for Payer: Superior Health Plan CHIP/Medicaid	$253.99
Rate for Payer: Superior Health Plan EPO	$47.98

DRILL QUICK RELEASE 1/8 STERILE 2PK

Facility

$352.76

Hospital Charge Code	144893
Hospital Revenue Code	272
Rate for Payer: Cash Price	$239.88

DRILL R3CON 2.4 X 140

Facility

$844.44

Hospital Charge Code	146419
Hospital Revenue Code	272
Min. Negotiated Rate	$76.00
Max. Negotiated Rate	$608.00
Rate for Payer: Amerigroup CHIP/Medicaid	$76.00
Rate for Payer: BCBS of TX Blue Advantage	$253.33
Rate for Payer: BCBS of TX Blue Essentials	$304.00
Rate for Payer: BCBS of TX PPO	$337.78
Rate for Payer: Cash Price	$574.22
Rate for Payer: Cigna Medicaid	$608.00
Rate for Payer: Molina CHIP/Medicaid	$608.00
Rate for Payer: Multiplan Auto	$548.89
Rate for Payer: Multiplan Commercial	$548.89
Rate for Payer: Multiplan Workers Comp	$548.89
Rate for Payer: Parkland Medicaid	$608.00
Rate for Payer: Scott and White EPO/PPO	$422.22
Rate for Payer: Superior Health Plan CHIP/Medicaid	$608.00
Rate for Payer: Superior Health Plan EPO	$114.84

DRILL R3CON 2.4 X 140

Facility

$844.44

Hospital Charge Code	146419
Hospital Revenue Code	272
Rate for Payer: Cash Price	$574.22

DRILL TIP -- DHF

Facility

$3,364.30

Hospital Charge Code	80810955
Hospital Revenue Code	272
Min. Negotiated Rate	$302.79
Max. Negotiated Rate	$2,422.30
Rate for Payer: Amerigroup CHIP/Medicaid	$302.79
Rate for Payer: BCBS of TX Blue Advantage	$1,009.29
Rate for Payer: BCBS of TX Blue Essentials	$1,211.15
Rate for Payer: BCBS of TX PPO	$1,345.72
Rate for Payer: Cash Price	$2,287.72
Rate for Payer: Cigna Medicaid	$2,422.30
Rate for Payer: Molina CHIP/Medicaid	$2,422.30
Rate for Payer: Multiplan Auto	$2,186.80
Rate for Payer: Multiplan Commercial	$2,186.80
Rate for Payer: Multiplan Workers Comp	$2,186.80
Rate for Payer: Parkland Medicaid	$2,422.30
Rate for Payer: Scott and White EPO/PPO	$1,682.15
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2,422.30
Rate for Payer: Superior Health Plan EPO	$457.54

DRILL TIP -- DHF

Facility

$3,364.30

Hospital Charge Code	80810955
Hospital Revenue Code	272
Rate for Payer: Cash Price	$2,287.72

DRILL TWIST -- DHF

Facility

$62.04

Hospital Charge Code	80911423
Hospital Revenue Code	272
Rate for Payer: Cash Price	$42.19

DRILL TWIST -- DHF

Facility

$62.04

Hospital Charge Code	80911423
Hospital Revenue Code	272
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$44.67
Rate for Payer: Amerigroup CHIP/Medicaid	$5.58
Rate for Payer: BCBS of TX Blue Advantage	$18.61
Rate for Payer: BCBS of TX Blue Essentials	$22.33
Rate for Payer: BCBS of TX PPO	$24.82
Rate for Payer: Cash Price	$42.19
Rate for Payer: Cigna Medicaid	$44.67
Rate for Payer: Molina CHIP/Medicaid	$44.67
Rate for Payer: Multiplan Auto	$40.33
Rate for Payer: Multiplan Commercial	$40.33
Rate for Payer: Multiplan Workers Comp	$40.33
Rate for Payer: Parkland Medicaid	$44.67
Rate for Payer: Scott and White EPO/PPO	$31.02
Rate for Payer: Superior Health Plan CHIP/Medicaid	$44.67
Rate for Payer: Superior Health Plan EPO	$8.44

Know your out-of-pocket cost for care.

All Charges