White Rock Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 1792: DEFIBRILLATOR IMPLANTS

Facility

$4.68

Service Code	APR-DRG 1792
Hospital Charge Code	APRDRG 1792
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$4.68
Rate for Payer: Amerigroup CHIP/Medicaid	$4.68
Rate for Payer: Cigna Medicaid	$4.68
Rate for Payer: Molina CHIP/Medicaid	$4.68
Rate for Payer: Parkland Medicaid	$4.68
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.68

INPATIENT APRDRG 1793: DEFIBRILLATOR IMPLANTS

Facility

$5.53

Service Code	APR-DRG 1793
Hospital Charge Code	APRDRG 1793
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$5.53
Rate for Payer: Amerigroup CHIP/Medicaid	$5.53
Rate for Payer: Cigna Medicaid	$5.53
Rate for Payer: Molina CHIP/Medicaid	$5.53
Rate for Payer: Parkland Medicaid	$5.53
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.53

INPATIENT APRDRG 1794: DEFIBRILLATOR IMPLANTS

Facility

$7.21

Service Code	APR-DRG 1794
Hospital Charge Code	APRDRG 1794
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$7.21
Rate for Payer: Amerigroup CHIP/Medicaid	$7.21
Rate for Payer: Cigna Medicaid	$7.21
Rate for Payer: Molina CHIP/Medicaid	$7.21
Rate for Payer: Parkland Medicaid	$7.21
Rate for Payer: Superior Health Plan CHIP/Medicaid	$7.21

INPATIENT APRDRG 1801: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$6.02

Service Code	APR-DRG 1801
Hospital Charge Code	APRDRG 1801
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$6.02
Rate for Payer: Amerigroup CHIP/Medicaid	$6.02
Rate for Payer: Cigna Medicaid	$6.02
Rate for Payer: Molina CHIP/Medicaid	$6.02
Rate for Payer: Parkland Medicaid	$6.02
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.02

INPATIENT APRDRG 1802: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$5.16

Service Code	APR-DRG 1802
Hospital Charge Code	APRDRG 1802
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$5.16
Rate for Payer: Amerigroup CHIP/Medicaid	$5.16
Rate for Payer: Cigna Medicaid	$5.16
Rate for Payer: Molina CHIP/Medicaid	$5.16
Rate for Payer: Parkland Medicaid	$5.16
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.16

INPATIENT APRDRG 1803: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$4.30

Service Code	APR-DRG 1803
Hospital Charge Code	APRDRG 1803
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$4.30
Rate for Payer: Amerigroup CHIP/Medicaid	$4.30
Rate for Payer: Cigna Medicaid	$4.30
Rate for Payer: Molina CHIP/Medicaid	$4.30
Rate for Payer: Parkland Medicaid	$4.30
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.30

INPATIENT APRDRG 1804: OTHER CIRCULATORY SYSTEM PROCEDURES

Facility

$6.64

Service Code	APR-DRG 1804
Hospital Charge Code	APRDRG 1804
Min. Negotiated Rate	$6.64
Max. Negotiated Rate	$6.64
Rate for Payer: Amerigroup CHIP/Medicaid	$6.64
Rate for Payer: Cigna Medicaid	$6.64
Rate for Payer: Molina CHIP/Medicaid	$6.64
Rate for Payer: Parkland Medicaid	$6.64
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.64

INPATIENT APRDRG 1811: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$1.84

Service Code	APR-DRG 1811
Hospital Charge Code	APRDRG 1811
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$1.84
Rate for Payer: Amerigroup CHIP/Medicaid	$1.84
Rate for Payer: Cigna Medicaid	$1.84
Rate for Payer: Molina CHIP/Medicaid	$1.84
Rate for Payer: Parkland Medicaid	$1.84
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.84

INPATIENT APRDRG 1812: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$2.79

Service Code	APR-DRG 1812
Hospital Charge Code	APRDRG 1812
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$2.79
Rate for Payer: Amerigroup CHIP/Medicaid	$2.79
Rate for Payer: Cigna Medicaid	$2.79
Rate for Payer: Molina CHIP/Medicaid	$2.79
Rate for Payer: Parkland Medicaid	$2.79
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.79

INPATIENT APRDRG 1813: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$4.60

Service Code	APR-DRG 1813
Hospital Charge Code	APRDRG 1813
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$4.60
Rate for Payer: Amerigroup CHIP/Medicaid	$4.60
Rate for Payer: Cigna Medicaid	$4.60
Rate for Payer: Molina CHIP/Medicaid	$4.60
Rate for Payer: Parkland Medicaid	$4.60
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.60

INPATIENT APRDRG 1814: LOWER EXTREMITY ARTERIAL PROCEDURES

Facility

$8.77

Service Code	APR-DRG 1814
Hospital Charge Code	APRDRG 1814
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$8.77
Rate for Payer: Amerigroup CHIP/Medicaid	$8.77
Rate for Payer: Cigna Medicaid	$8.77
Rate for Payer: Molina CHIP/Medicaid	$8.77
Rate for Payer: Parkland Medicaid	$8.77
Rate for Payer: Superior Health Plan CHIP/Medicaid	$8.77

INPATIENT APRDRG 1821: OTHER PERIPHERAL VASCULAR PROCEDURES

Facility

$2.06

Service Code	APR-DRG 1821
Hospital Charge Code	APRDRG 1821
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.06
Rate for Payer: Amerigroup CHIP/Medicaid	$2.06
Rate for Payer: Cigna Medicaid	$2.06
Rate for Payer: Molina CHIP/Medicaid	$2.06
Rate for Payer: Parkland Medicaid	$2.06
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.06

INPATIENT APRDRG 1822: OTHER PERIPHERAL VASCULAR PROCEDURES

Facility

$2.89

Service Code	APR-DRG 1822
Hospital Charge Code	APRDRG 1822
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Amerigroup CHIP/Medicaid	$2.89
Rate for Payer: Cigna Medicaid	$2.89
Rate for Payer: Molina CHIP/Medicaid	$2.89
Rate for Payer: Parkland Medicaid	$2.89
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.89

INPATIENT APRDRG 1823: OTHER PERIPHERAL VASCULAR PROCEDURES

Facility

$3.82

Service Code	APR-DRG 1823
Hospital Charge Code	APRDRG 1823
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$3.82
Rate for Payer: Amerigroup CHIP/Medicaid	$3.82
Rate for Payer: Cigna Medicaid	$3.82
Rate for Payer: Molina CHIP/Medicaid	$3.82
Rate for Payer: Parkland Medicaid	$3.82
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.82

INPATIENT APRDRG 1824: OTHER PERIPHERAL VASCULAR PROCEDURES

Facility

$11.27

Service Code	APR-DRG 1824
Hospital Charge Code	APRDRG 1824
Min. Negotiated Rate	$11.27
Max. Negotiated Rate	$11.27
Rate for Payer: Amerigroup CHIP/Medicaid	$11.27
Rate for Payer: Cigna Medicaid	$11.27
Rate for Payer: Molina CHIP/Medicaid	$11.27
Rate for Payer: Parkland Medicaid	$11.27
Rate for Payer: Superior Health Plan CHIP/Medicaid	$11.27

INPATIENT APRDRG 1831: PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$5.11

Service Code	APR-DRG 1831
Hospital Charge Code	APRDRG 1831
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$5.11
Rate for Payer: Amerigroup CHIP/Medicaid	$5.11
Rate for Payer: Cigna Medicaid	$5.11
Rate for Payer: Molina CHIP/Medicaid	$5.11
Rate for Payer: Parkland Medicaid	$5.11
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.11

INPATIENT APRDRG 1832: PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$5.37

Service Code	APR-DRG 1832
Hospital Charge Code	APRDRG 1832
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$5.37
Rate for Payer: Amerigroup CHIP/Medicaid	$5.37
Rate for Payer: Cigna Medicaid	$5.37
Rate for Payer: Molina CHIP/Medicaid	$5.37
Rate for Payer: Parkland Medicaid	$5.37
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.37

INPATIENT APRDRG 1833: PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$8.27

Service Code	APR-DRG 1833
Hospital Charge Code	APRDRG 1833
Min. Negotiated Rate	$8.27
Max. Negotiated Rate	$8.27
Rate for Payer: Amerigroup CHIP/Medicaid	$8.27
Rate for Payer: Cigna Medicaid	$8.27
Rate for Payer: Molina CHIP/Medicaid	$8.27
Rate for Payer: Parkland Medicaid	$8.27
Rate for Payer: Superior Health Plan CHIP/Medicaid	$8.27

INPATIENT APRDRG 1834: PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$8.48

Service Code	APR-DRG 1834
Hospital Charge Code	APRDRG 1834
Min. Negotiated Rate	$8.48
Max. Negotiated Rate	$8.48
Rate for Payer: Amerigroup CHIP/Medicaid	$8.48
Rate for Payer: Cigna Medicaid	$8.48
Rate for Payer: Molina CHIP/Medicaid	$8.48
Rate for Payer: Parkland Medicaid	$8.48
Rate for Payer: Superior Health Plan CHIP/Medicaid	$8.48

INPATIENT APRDRG 1901: ACUTE MYOCARDIAL INFARCTION

Facility

$0.99

Service Code	APR-DRG 1901
Hospital Charge Code	APRDRG 1901
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Amerigroup CHIP/Medicaid	$0.99
Rate for Payer: Cigna Medicaid	$0.99
Rate for Payer: Molina CHIP/Medicaid	$0.99
Rate for Payer: Parkland Medicaid	$0.99
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.99

INPATIENT APRDRG 1902: ACUTE MYOCARDIAL INFARCTION

Facility

$1.06

Service Code	APR-DRG 1902
Hospital Charge Code	APRDRG 1902
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Amerigroup CHIP/Medicaid	$1.06
Rate for Payer: Cigna Medicaid	$1.06
Rate for Payer: Molina CHIP/Medicaid	$1.06
Rate for Payer: Parkland Medicaid	$1.06
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.06

INPATIENT APRDRG 1903: ACUTE MYOCARDIAL INFARCTION

Facility

$1.41

Service Code	APR-DRG 1903
Hospital Charge Code	APRDRG 1903
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$1.41
Rate for Payer: Amerigroup CHIP/Medicaid	$1.41
Rate for Payer: Cigna Medicaid	$1.41
Rate for Payer: Molina CHIP/Medicaid	$1.41
Rate for Payer: Parkland Medicaid	$1.41
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.41

INPATIENT APRDRG 1904: ACUTE MYOCARDIAL INFARCTION

Facility

$2.49

Service Code	APR-DRG 1904
Hospital Charge Code	APRDRG 1904
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$2.49
Rate for Payer: Amerigroup CHIP/Medicaid	$2.49
Rate for Payer: Cigna Medicaid	$2.49
Rate for Payer: Molina CHIP/Medicaid	$2.49
Rate for Payer: Parkland Medicaid	$2.49
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.49

INPATIENT APRDRG 1911: CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$1.09

Service Code	APR-DRG 1911
Hospital Charge Code	APRDRG 1911
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Amerigroup CHIP/Medicaid	$1.09
Rate for Payer: Cigna Medicaid	$1.09
Rate for Payer: Molina CHIP/Medicaid	$1.09
Rate for Payer: Parkland Medicaid	$1.09
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.09

INPATIENT APRDRG 1912: CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$1.29

Service Code	APR-DRG 1912
Hospital Charge Code	APRDRG 1912
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Amerigroup CHIP/Medicaid	$1.29
Rate for Payer: Cigna Medicaid	$1.29
Rate for Payer: Molina CHIP/Medicaid	$1.29
Rate for Payer: Parkland Medicaid	$1.29
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.29

Know your out-of-pocket cost for care.

All Charges