White Rock Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 1913: CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$1.80

Service Code	APR-DRG 1913
Hospital Charge Code	APRDRG 1913
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Amerigroup CHIP/Medicaid	$1.80
Rate for Payer: Cigna Medicaid	$1.80
Rate for Payer: Molina CHIP/Medicaid	$1.80
Rate for Payer: Parkland Medicaid	$1.80
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.80

INPATIENT APRDRG 1914: CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE

Facility

$2.24

Service Code	APR-DRG 1914
Hospital Charge Code	APRDRG 1914
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$2.24
Rate for Payer: Amerigroup CHIP/Medicaid	$2.24
Rate for Payer: Cigna Medicaid	$2.24
Rate for Payer: Molina CHIP/Medicaid	$2.24
Rate for Payer: Parkland Medicaid	$2.24
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.24

INPATIENT APRDRG 1921: CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$1.54

Service Code	APR-DRG 1921
Hospital Charge Code	APRDRG 1921
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Amerigroup CHIP/Medicaid	$1.54
Rate for Payer: Cigna Medicaid	$1.54
Rate for Payer: Molina CHIP/Medicaid	$1.54
Rate for Payer: Parkland Medicaid	$1.54
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.54

INPATIENT APRDRG 1922: CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$1.66

Service Code	APR-DRG 1922
Hospital Charge Code	APRDRG 1922
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$1.66
Rate for Payer: Amerigroup CHIP/Medicaid	$1.66
Rate for Payer: Cigna Medicaid	$1.66
Rate for Payer: Molina CHIP/Medicaid	$1.66
Rate for Payer: Parkland Medicaid	$1.66
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.66

INPATIENT APRDRG 1923: CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$2.84

Service Code	APR-DRG 1923
Hospital Charge Code	APRDRG 1923
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$2.84
Rate for Payer: Amerigroup CHIP/Medicaid	$2.84
Rate for Payer: Cigna Medicaid	$2.84
Rate for Payer: Molina CHIP/Medicaid	$2.84
Rate for Payer: Parkland Medicaid	$2.84
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.84

INPATIENT APRDRG 1924: CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS

Facility

$4.59

Service Code	APR-DRG 1924
Hospital Charge Code	APRDRG 1924
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$4.59
Rate for Payer: Amerigroup CHIP/Medicaid	$4.59
Rate for Payer: Cigna Medicaid	$4.59
Rate for Payer: Molina CHIP/Medicaid	$4.59
Rate for Payer: Parkland Medicaid	$4.59
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.59

INPATIENT APRDRG 1931: ACUTE & SUBACUTE ENDOCARDITIS

Facility

$2.12

Service Code	APR-DRG 1931
Hospital Charge Code	APRDRG 1931
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Amerigroup CHIP/Medicaid	$2.12
Rate for Payer: Cigna Medicaid	$2.12
Rate for Payer: Molina CHIP/Medicaid	$2.12
Rate for Payer: Parkland Medicaid	$2.12
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.12

INPATIENT APRDRG 1932: ACUTE & SUBACUTE ENDOCARDITIS

Facility

$2.72

Service Code	APR-DRG 1932
Hospital Charge Code	APRDRG 1932
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$2.72
Rate for Payer: Amerigroup CHIP/Medicaid	$2.72
Rate for Payer: Cigna Medicaid	$2.72
Rate for Payer: Molina CHIP/Medicaid	$2.72
Rate for Payer: Parkland Medicaid	$2.72
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.72

INPATIENT APRDRG 1933: ACUTE & SUBACUTE ENDOCARDITIS

Facility

$4.54

Service Code	APR-DRG 1933
Hospital Charge Code	APRDRG 1933
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Amerigroup CHIP/Medicaid	$4.54
Rate for Payer: Cigna Medicaid	$4.54
Rate for Payer: Molina CHIP/Medicaid	$4.54
Rate for Payer: Parkland Medicaid	$4.54
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.54

INPATIENT APRDRG 1934: ACUTE & SUBACUTE ENDOCARDITIS

Facility

$5.41

Service Code	APR-DRG 1934
Hospital Charge Code	APRDRG 1934
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$5.41
Rate for Payer: Amerigroup CHIP/Medicaid	$5.41
Rate for Payer: Cigna Medicaid	$5.41
Rate for Payer: Molina CHIP/Medicaid	$5.41
Rate for Payer: Parkland Medicaid	$5.41
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.41

INPATIENT APRDRG 1941: HEART FAILURE

Facility

$0.65

Service Code	APR-DRG 1941
Hospital Charge Code	APRDRG 1941
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Amerigroup CHIP/Medicaid	$0.65
Rate for Payer: Cigna Medicaid	$0.65
Rate for Payer: Molina CHIP/Medicaid	$0.65
Rate for Payer: Parkland Medicaid	$0.65
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.65

INPATIENT APRDRG 1942: HEART FAILURE

Facility

$0.86

Service Code	APR-DRG 1942
Hospital Charge Code	APRDRG 1942
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Amerigroup CHIP/Medicaid	$0.86
Rate for Payer: Cigna Medicaid	$0.86
Rate for Payer: Molina CHIP/Medicaid	$0.86
Rate for Payer: Parkland Medicaid	$0.86
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.86

INPATIENT APRDRG 1943: HEART FAILURE

Facility

$1.32

Service Code	APR-DRG 1943
Hospital Charge Code	APRDRG 1943
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$1.32
Rate for Payer: Amerigroup CHIP/Medicaid	$1.32
Rate for Payer: Cigna Medicaid	$1.32
Rate for Payer: Molina CHIP/Medicaid	$1.32
Rate for Payer: Parkland Medicaid	$1.32
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.32

INPATIENT APRDRG 1944: HEART FAILURE

Facility

$3.27

Service Code	APR-DRG 1944
Hospital Charge Code	APRDRG 1944
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$3.27
Rate for Payer: Amerigroup CHIP/Medicaid	$3.27
Rate for Payer: Cigna Medicaid	$3.27
Rate for Payer: Molina CHIP/Medicaid	$3.27
Rate for Payer: Parkland Medicaid	$3.27
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.27

INPATIENT APRDRG 1961: CARDIAC ARREST & SHOCK

Facility

$0.65

Service Code	APR-DRG 1961
Hospital Charge Code	APRDRG 1961
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Amerigroup CHIP/Medicaid	$0.65
Rate for Payer: Cigna Medicaid	$0.65
Rate for Payer: Molina CHIP/Medicaid	$0.65
Rate for Payer: Parkland Medicaid	$0.65
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.65

INPATIENT APRDRG 1962: CARDIAC ARREST & SHOCK

Facility

$0.86

Service Code	APR-DRG 1962
Hospital Charge Code	APRDRG 1962
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Amerigroup CHIP/Medicaid	$0.86
Rate for Payer: Cigna Medicaid	$0.86
Rate for Payer: Molina CHIP/Medicaid	$0.86
Rate for Payer: Parkland Medicaid	$0.86
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.86

INPATIENT APRDRG 1963: CARDIAC ARREST & SHOCK

Facility

$1.26

Service Code	APR-DRG 1963
Hospital Charge Code	APRDRG 1963
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$1.26
Rate for Payer: Amerigroup CHIP/Medicaid	$1.26
Rate for Payer: Cigna Medicaid	$1.26
Rate for Payer: Molina CHIP/Medicaid	$1.26
Rate for Payer: Parkland Medicaid	$1.26
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.26

INPATIENT APRDRG 1964: CARDIAC ARREST & SHOCK

Facility

$2.69

Service Code	APR-DRG 1964
Hospital Charge Code	APRDRG 1964
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Amerigroup CHIP/Medicaid	$2.69
Rate for Payer: Cigna Medicaid	$2.69
Rate for Payer: Molina CHIP/Medicaid	$2.69
Rate for Payer: Parkland Medicaid	$2.69
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.69

INPATIENT APRDRG 1971: PERIPHERAL & OTHER VASCULAR DISORDERS

Facility

$0.74

Service Code	APR-DRG 1971
Hospital Charge Code	APRDRG 1971
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$0.74
Rate for Payer: Amerigroup CHIP/Medicaid	$0.74
Rate for Payer: Cigna Medicaid	$0.74
Rate for Payer: Molina CHIP/Medicaid	$0.74
Rate for Payer: Parkland Medicaid	$0.74
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.74

INPATIENT APRDRG 1972: PERIPHERAL & OTHER VASCULAR DISORDERS

Facility

$1.06

Service Code	APR-DRG 1972
Hospital Charge Code	APRDRG 1972
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 1973: PERIPHERAL & OTHER VASCULAR DISORDERS

Facility

$1.40

Service Code	APR-DRG 1973
Hospital Charge Code	APRDRG 1973
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$1.40
Rate for Payer: Amerigroup CHIP/Medicaid	$1.40
Rate for Payer: Cigna Medicaid	$1.40
Rate for Payer: Molina CHIP/Medicaid	$1.40
Rate for Payer: Parkland Medicaid	$1.40
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.40

INPATIENT APRDRG 1974: PERIPHERAL & OTHER VASCULAR DISORDERS

Facility

$3.04

Service Code	APR-DRG 1974
Hospital Charge Code	APRDRG 1974
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Amerigroup CHIP/Medicaid	$3.04
Rate for Payer: Cigna Medicaid	$3.04
Rate for Payer: Molina CHIP/Medicaid	$3.04
Rate for Payer: Parkland Medicaid	$3.04
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.04

INPATIENT APRDRG 1981: ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS

Facility

$0.62

Service Code	APR-DRG 1981
Hospital Charge Code	APRDRG 1981
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Amerigroup CHIP/Medicaid	$0.62
Rate for Payer: Cigna Medicaid	$0.62
Rate for Payer: Molina CHIP/Medicaid	$0.62
Rate for Payer: Parkland Medicaid	$0.62
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.62

INPATIENT APRDRG 1982: ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS

Facility

$0.79

Service Code	APR-DRG 1982
Hospital Charge Code	APRDRG 1982
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Amerigroup CHIP/Medicaid	$0.79
Rate for Payer: Cigna Medicaid	$0.79
Rate for Payer: Molina CHIP/Medicaid	$0.79
Rate for Payer: Parkland Medicaid	$0.79
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.79

INPATIENT APRDRG 1983: ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS

Facility

$0.97

Service Code	APR-DRG 1983
Hospital Charge Code	APRDRG 1983
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Amerigroup CHIP/Medicaid	$0.97
Rate for Payer: Cigna Medicaid	$0.97
Rate for Payer: Molina CHIP/Medicaid	$0.97
Rate for Payer: Parkland Medicaid	$0.97
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.97

Know your out-of-pocket cost for care.

All Charges