White Rock Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 1984: ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS

Facility

$1.64

Service Code	APR-DRG 1984
Hospital Charge Code	APRDRG 1984
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Amerigroup CHIP/Medicaid	$1.64
Rate for Payer: Cigna Medicaid	$1.64
Rate for Payer: Molina CHIP/Medicaid	$1.64
Rate for Payer: Parkland Medicaid	$1.64
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.64

INPATIENT APRDRG 1991: HYPERTENSION

Facility

$0.74

Service Code	APR-DRG 1991
Hospital Charge Code	APRDRG 1991
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 1992: HYPERTENSION

Facility

$0.80

Service Code	APR-DRG 1992
Hospital Charge Code	APRDRG 1992
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Amerigroup CHIP/Medicaid	$0.80
Rate for Payer: Cigna Medicaid	$0.80
Rate for Payer: Molina CHIP/Medicaid	$0.80
Rate for Payer: Parkland Medicaid	$0.80
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.80

INPATIENT APRDRG 1993: HYPERTENSION

Facility

$1.17

Service Code	APR-DRG 1993
Hospital Charge Code	APRDRG 1993
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Amerigroup CHIP/Medicaid	$1.17
Rate for Payer: Cigna Medicaid	$1.17
Rate for Payer: Molina CHIP/Medicaid	$1.17
Rate for Payer: Parkland Medicaid	$1.17
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.17

INPATIENT APRDRG 1994: HYPERTENSION

Facility

$2.15

Service Code	APR-DRG 1994
Hospital Charge Code	APRDRG 1994
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$2.15
Rate for Payer: Amerigroup CHIP/Medicaid	$2.15
Rate for Payer: Cigna Medicaid	$2.15
Rate for Payer: Molina CHIP/Medicaid	$2.15
Rate for Payer: Parkland Medicaid	$2.15
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.15

INPATIENT APRDRG 2001: CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$1.52

Service Code	APR-DRG 2001
Hospital Charge Code	APRDRG 2001
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Amerigroup CHIP/Medicaid	$1.52
Rate for Payer: Cigna Medicaid	$1.52
Rate for Payer: Molina CHIP/Medicaid	$1.52
Rate for Payer: Parkland Medicaid	$1.52
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.52

INPATIENT APRDRG 2002: CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$2.53

Service Code	APR-DRG 2002
Hospital Charge Code	APRDRG 2002
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Amerigroup CHIP/Medicaid	$2.53
Rate for Payer: Cigna Medicaid	$2.53
Rate for Payer: Molina CHIP/Medicaid	$2.53
Rate for Payer: Parkland Medicaid	$2.53
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.53

INPATIENT APRDRG 2003: CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$3.55

Service Code	APR-DRG 2003
Hospital Charge Code	APRDRG 2003
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$3.55
Rate for Payer: Amerigroup CHIP/Medicaid	$3.55
Rate for Payer: Cigna Medicaid	$3.55
Rate for Payer: Molina CHIP/Medicaid	$3.55
Rate for Payer: Parkland Medicaid	$3.55
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.55

INPATIENT APRDRG 2004: CARDIAC STRUCTURAL & VALVULAR DISORDERS

Facility

$28.28

Service Code	APR-DRG 2004
Hospital Charge Code	APRDRG 2004
Min. Negotiated Rate	$28.28
Max. Negotiated Rate	$28.28
Rate for Payer: Amerigroup CHIP/Medicaid	$28.28
Rate for Payer: Cigna Medicaid	$28.28
Rate for Payer: Molina CHIP/Medicaid	$28.28
Rate for Payer: Parkland Medicaid	$28.28
Rate for Payer: Superior Health Plan CHIP/Medicaid	$28.28

INPATIENT APRDRG 2011: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$0.61

Service Code	APR-DRG 2011
Hospital Charge Code	APRDRG 2011
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.61
Rate for Payer: Amerigroup CHIP/Medicaid	$0.61
Rate for Payer: Cigna Medicaid	$0.61
Rate for Payer: Molina CHIP/Medicaid	$0.61
Rate for Payer: Parkland Medicaid	$0.61
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.61

INPATIENT APRDRG 2012: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$0.77

Service Code	APR-DRG 2012
Hospital Charge Code	APRDRG 2012
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Amerigroup CHIP/Medicaid	$0.77
Rate for Payer: Cigna Medicaid	$0.77
Rate for Payer: Molina CHIP/Medicaid	$0.77
Rate for Payer: Parkland Medicaid	$0.77
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.77

INPATIENT APRDRG 2013: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$1.19

Service Code	APR-DRG 2013
Hospital Charge Code	APRDRG 2013
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Amerigroup CHIP/Medicaid	$1.19
Rate for Payer: Cigna Medicaid	$1.19
Rate for Payer: Molina CHIP/Medicaid	$1.19
Rate for Payer: Parkland Medicaid	$1.19
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.19

INPATIENT APRDRG 2014: CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS

Facility

$1.96

Service Code	APR-DRG 2014
Hospital Charge Code	APRDRG 2014
Min. Negotiated Rate	$1.96
Max. Negotiated Rate	$1.96
Rate for Payer: Amerigroup CHIP/Medicaid	$1.96
Rate for Payer: Cigna Medicaid	$1.96
Rate for Payer: Molina CHIP/Medicaid	$1.96
Rate for Payer: Parkland Medicaid	$1.96
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.96

INPATIENT APRDRG 2031: CHEST PAIN

Facility

$0.60

Service Code	APR-DRG 2031
Hospital Charge Code	APRDRG 2031
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Amerigroup CHIP/Medicaid	$0.60
Rate for Payer: Cigna Medicaid	$0.60
Rate for Payer: Molina CHIP/Medicaid	$0.60
Rate for Payer: Parkland Medicaid	$0.60
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.60

INPATIENT APRDRG 2032: CHEST PAIN

Facility

$0.72

Service Code	APR-DRG 2032
Hospital Charge Code	APRDRG 2032
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Amerigroup CHIP/Medicaid	$0.72
Rate for Payer: Cigna Medicaid	$0.72
Rate for Payer: Molina CHIP/Medicaid	$0.72
Rate for Payer: Parkland Medicaid	$0.72
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.72

INPATIENT APRDRG 2033: CHEST PAIN

Facility

$0.79

Service Code	APR-DRG 2033
Hospital Charge Code	APRDRG 2033
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 2034: CHEST PAIN

Facility

$1.62

Service Code	APR-DRG 2034
Hospital Charge Code	APRDRG 2034
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$1.62
Rate for Payer: Amerigroup CHIP/Medicaid	$1.62
Rate for Payer: Cigna Medicaid	$1.62
Rate for Payer: Molina CHIP/Medicaid	$1.62
Rate for Payer: Parkland Medicaid	$1.62
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.62

INPATIENT APRDRG 2041: SYNCOPE & COLLAPSE

Facility

$0.64

Service Code	APR-DRG 2041
Hospital Charge Code	APRDRG 2041
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Amerigroup CHIP/Medicaid	$0.64
Rate for Payer: Cigna Medicaid	$0.64
Rate for Payer: Molina CHIP/Medicaid	$0.64
Rate for Payer: Parkland Medicaid	$0.64
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.64

INPATIENT APRDRG 2042: SYNCOPE & COLLAPSE

Facility

$0.85

Service Code	APR-DRG 2042
Hospital Charge Code	APRDRG 2042
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Amerigroup CHIP/Medicaid	$0.85
Rate for Payer: Cigna Medicaid	$0.85
Rate for Payer: Molina CHIP/Medicaid	$0.85
Rate for Payer: Parkland Medicaid	$0.85
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.85

INPATIENT APRDRG 2043: SYNCOPE & COLLAPSE

Facility

$0.94

Service Code	APR-DRG 2043
Hospital Charge Code	APRDRG 2043
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Amerigroup CHIP/Medicaid	$0.94
Rate for Payer: Cigna Medicaid	$0.94
Rate for Payer: Molina CHIP/Medicaid	$0.94
Rate for Payer: Parkland Medicaid	$0.94
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.94

INPATIENT APRDRG 2044: SYNCOPE & COLLAPSE

Facility

$3.12

Service Code	APR-DRG 2044
Hospital Charge Code	APRDRG 2044
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$3.12
Rate for Payer: Amerigroup CHIP/Medicaid	$3.12
Rate for Payer: Cigna Medicaid	$3.12
Rate for Payer: Molina CHIP/Medicaid	$3.12
Rate for Payer: Parkland Medicaid	$3.12
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.12

INPATIENT APRDRG 2051: CARDIOMYOPATHY

Facility

$0.70

Service Code	APR-DRG 2051
Hospital Charge Code	APRDRG 2051
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$0.70
Rate for Payer: Amerigroup CHIP/Medicaid	$0.70
Rate for Payer: Cigna Medicaid	$0.70
Rate for Payer: Molina CHIP/Medicaid	$0.70
Rate for Payer: Parkland Medicaid	$0.70
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.70

INPATIENT APRDRG 2052: CARDIOMYOPATHY

Facility

$0.93

Service Code	APR-DRG 2052
Hospital Charge Code	APRDRG 2052
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$0.93
Rate for Payer: Amerigroup CHIP/Medicaid	$0.93
Rate for Payer: Cigna Medicaid	$0.93
Rate for Payer: Molina CHIP/Medicaid	$0.93
Rate for Payer: Parkland Medicaid	$0.93
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.93

INPATIENT APRDRG 2053: CARDIOMYOPATHY

Facility

$1.18

Service Code	APR-DRG 2053
Hospital Charge Code	APRDRG 2053
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Amerigroup CHIP/Medicaid	$1.18
Rate for Payer: Cigna Medicaid	$1.18
Rate for Payer: Molina CHIP/Medicaid	$1.18
Rate for Payer: Parkland Medicaid	$1.18
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.18

INPATIENT APRDRG 2054: CARDIOMYOPATHY

Facility

$11.05

Service Code	APR-DRG 2054
Hospital Charge Code	APRDRG 2054
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Amerigroup CHIP/Medicaid	$11.05
Rate for Payer: Cigna Medicaid	$11.05
Rate for Payer: Molina CHIP/Medicaid	$11.05
Rate for Payer: Parkland Medicaid	$11.05
Rate for Payer: Superior Health Plan CHIP/Medicaid	$11.05

Know your out-of-pocket cost for care.

All Charges