White Rock Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 2262: ANAL PROCEDURES

Facility

$1.63

Service Code	APR-DRG 2262
Hospital Charge Code	APRDRG 2262
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$1.63
Rate for Payer: Amerigroup CHIP/Medicaid	$1.63
Rate for Payer: Cigna Medicaid	$1.63
Rate for Payer: Molina CHIP/Medicaid	$1.63
Rate for Payer: Parkland Medicaid	$1.63
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.63

INPATIENT APRDRG 2263: ANAL PROCEDURES

Facility

$1.89

Service Code	APR-DRG 2263
Hospital Charge Code	APRDRG 2263
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$1.89
Rate for Payer: Amerigroup CHIP/Medicaid	$1.89
Rate for Payer: Cigna Medicaid	$1.89
Rate for Payer: Molina CHIP/Medicaid	$1.89
Rate for Payer: Parkland Medicaid	$1.89
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.89

INPATIENT APRDRG 2264: ANAL PROCEDURES

Facility

$5.51

Service Code	APR-DRG 2264
Hospital Charge Code	APRDRG 2264
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$5.51
Rate for Payer: Amerigroup CHIP/Medicaid	$5.51
Rate for Payer: Cigna Medicaid	$5.51
Rate for Payer: Molina CHIP/Medicaid	$5.51
Rate for Payer: Parkland Medicaid	$5.51
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.51

INPATIENT APRDRG 2271: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL

Facility

$1.46

Service Code	APR-DRG 2271
Hospital Charge Code	APRDRG 2271
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Amerigroup CHIP/Medicaid	$1.46
Rate for Payer: Cigna Medicaid	$1.46
Rate for Payer: Molina CHIP/Medicaid	$1.46
Rate for Payer: Parkland Medicaid	$1.46
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.46

INPATIENT APRDRG 2272: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL

Facility

$1.88

Service Code	APR-DRG 2272
Hospital Charge Code	APRDRG 2272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Amerigroup CHIP/Medicaid	$1.88
Rate for Payer: Cigna Medicaid	$1.88
Rate for Payer: Molina CHIP/Medicaid	$1.88
Rate for Payer: Parkland Medicaid	$1.88
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.88

INPATIENT APRDRG 2273: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL

Facility

$2.77

Service Code	APR-DRG 2273
Hospital Charge Code	APRDRG 2273
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Amerigroup CHIP/Medicaid	$2.77
Rate for Payer: Cigna Medicaid	$2.77
Rate for Payer: Molina CHIP/Medicaid	$2.77
Rate for Payer: Parkland Medicaid	$2.77
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.77

INPATIENT APRDRG 2274: HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL

Facility

$8.74

Service Code	APR-DRG 2274
Hospital Charge Code	APRDRG 2274
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$8.74
Rate for Payer: Amerigroup CHIP/Medicaid	$8.74
Rate for Payer: Cigna Medicaid	$8.74
Rate for Payer: Molina CHIP/Medicaid	$8.74
Rate for Payer: Parkland Medicaid	$8.74
Rate for Payer: Superior Health Plan CHIP/Medicaid	$8.74

INPATIENT APRDRG 2281: INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES

Facility

$1.02

Service Code	APR-DRG 2281
Hospital Charge Code	APRDRG 2281
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Amerigroup CHIP/Medicaid	$1.02
Rate for Payer: Cigna Medicaid	$1.02
Rate for Payer: Molina CHIP/Medicaid	$1.02
Rate for Payer: Parkland Medicaid	$1.02
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.02

INPATIENT APRDRG 2282: INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES

Facility

$1.38

Service Code	APR-DRG 2282
Hospital Charge Code	APRDRG 2282
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$1.38
Rate for Payer: Amerigroup CHIP/Medicaid	$1.38
Rate for Payer: Cigna Medicaid	$1.38
Rate for Payer: Molina CHIP/Medicaid	$1.38
Rate for Payer: Parkland Medicaid	$1.38
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.38

INPATIENT APRDRG 2283: INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES

Facility

$2.29

Service Code	APR-DRG 2283
Hospital Charge Code	APRDRG 2283
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Amerigroup CHIP/Medicaid	$2.29
Rate for Payer: Cigna Medicaid	$2.29
Rate for Payer: Molina CHIP/Medicaid	$2.29
Rate for Payer: Parkland Medicaid	$2.29
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.29

INPATIENT APRDRG 2284: INGUINAL, FEMORAL & UMBILICAL HERNIA PROCEDURES

Facility

$4.40

Service Code	APR-DRG 2284
Hospital Charge Code	APRDRG 2284
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$4.40
Rate for Payer: Amerigroup CHIP/Medicaid	$4.40
Rate for Payer: Cigna Medicaid	$4.40
Rate for Payer: Molina CHIP/Medicaid	$4.40
Rate for Payer: Parkland Medicaid	$4.40
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.40

INPATIENT APRDRG 2291: OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES

Facility

$1.36

Service Code	APR-DRG 2291
Hospital Charge Code	APRDRG 2291
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.36
Rate for Payer: Amerigroup CHIP/Medicaid	$1.36
Rate for Payer: Cigna Medicaid	$1.36
Rate for Payer: Molina CHIP/Medicaid	$1.36
Rate for Payer: Parkland Medicaid	$1.36
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.36

INPATIENT APRDRG 2292: OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES

Facility

$1.89

Service Code	APR-DRG 2292
Hospital Charge Code	APRDRG 2292
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$1.89
Rate for Payer: Amerigroup CHIP/Medicaid	$1.89
Rate for Payer: Cigna Medicaid	$1.89
Rate for Payer: Molina CHIP/Medicaid	$1.89
Rate for Payer: Parkland Medicaid	$1.89
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.89

INPATIENT APRDRG 2293: OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES

Facility

$3.84

Service Code	APR-DRG 2293
Hospital Charge Code	APRDRG 2293
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$3.84
Rate for Payer: Amerigroup CHIP/Medicaid	$3.84
Rate for Payer: Cigna Medicaid	$3.84
Rate for Payer: Molina CHIP/Medicaid	$3.84
Rate for Payer: Parkland Medicaid	$3.84
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.84

INPATIENT APRDRG 2294: OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES

Facility

$5.26

Service Code	APR-DRG 2294
Hospital Charge Code	APRDRG 2294
Min. Negotiated Rate	$5.26
Max. Negotiated Rate	$5.26
Rate for Payer: Amerigroup CHIP/Medicaid	$5.26
Rate for Payer: Cigna Medicaid	$5.26
Rate for Payer: Molina CHIP/Medicaid	$5.26
Rate for Payer: Parkland Medicaid	$5.26
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.26

INPATIENT APRDRG 2301: MAJOR SMALL BOWEL PROCEDURES

Facility

$1.78

Service Code	APR-DRG 2301
Hospital Charge Code	APRDRG 2301
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Amerigroup CHIP/Medicaid	$1.78
Rate for Payer: Cigna Medicaid	$1.78
Rate for Payer: Molina CHIP/Medicaid	$1.78
Rate for Payer: Parkland Medicaid	$1.78
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.78

INPATIENT APRDRG 2302: MAJOR SMALL BOWEL PROCEDURES

Facility

$2.61

Service Code	APR-DRG 2302
Hospital Charge Code	APRDRG 2302
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$2.61
Rate for Payer: Amerigroup CHIP/Medicaid	$2.61
Rate for Payer: Cigna Medicaid	$2.61
Rate for Payer: Molina CHIP/Medicaid	$2.61
Rate for Payer: Parkland Medicaid	$2.61
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.61

INPATIENT APRDRG 2303: MAJOR SMALL BOWEL PROCEDURES

Facility

$3.89

Service Code	APR-DRG 2303
Hospital Charge Code	APRDRG 2303
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$3.89
Rate for Payer: Amerigroup CHIP/Medicaid	$3.89
Rate for Payer: Cigna Medicaid	$3.89
Rate for Payer: Molina CHIP/Medicaid	$3.89
Rate for Payer: Parkland Medicaid	$3.89
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.89

INPATIENT APRDRG 2304: MAJOR SMALL BOWEL PROCEDURES

Facility

$10.57

Service Code	APR-DRG 2304
Hospital Charge Code	APRDRG 2304
Min. Negotiated Rate	$10.57
Max. Negotiated Rate	$10.57
Rate for Payer: Amerigroup CHIP/Medicaid	$10.57
Rate for Payer: Cigna Medicaid	$10.57
Rate for Payer: Molina CHIP/Medicaid	$10.57
Rate for Payer: Parkland Medicaid	$10.57
Rate for Payer: Superior Health Plan CHIP/Medicaid	$10.57

INPATIENT APRDRG 2311: MAJOR LARGE BOWEL PROCEDURES

Facility

$1.73

Service Code	APR-DRG 2311
Hospital Charge Code	APRDRG 2311
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$1.73
Rate for Payer: Amerigroup CHIP/Medicaid	$1.73
Rate for Payer: Cigna Medicaid	$1.73
Rate for Payer: Molina CHIP/Medicaid	$1.73
Rate for Payer: Parkland Medicaid	$1.73
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.73

INPATIENT APRDRG 2312: MAJOR LARGE BOWEL PROCEDURES

Facility

$2.20

Service Code	APR-DRG 2312
Hospital Charge Code	APRDRG 2312
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$2.20
Rate for Payer: Amerigroup CHIP/Medicaid	$2.20
Rate for Payer: Cigna Medicaid	$2.20
Rate for Payer: Molina CHIP/Medicaid	$2.20
Rate for Payer: Parkland Medicaid	$2.20
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.20

INPATIENT APRDRG 2313: MAJOR LARGE BOWEL PROCEDURES

Facility

$3.08

Service Code	APR-DRG 2313
Hospital Charge Code	APRDRG 2313
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$3.08
Rate for Payer: Amerigroup CHIP/Medicaid	$3.08
Rate for Payer: Cigna Medicaid	$3.08
Rate for Payer: Molina CHIP/Medicaid	$3.08
Rate for Payer: Parkland Medicaid	$3.08
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.08

INPATIENT APRDRG 2314: MAJOR LARGE BOWEL PROCEDURES

Facility

$6.41

Service Code	APR-DRG 2314
Hospital Charge Code	APRDRG 2314
Min. Negotiated Rate	$6.41
Max. Negotiated Rate	$6.41
Rate for Payer: Amerigroup CHIP/Medicaid	$6.41
Rate for Payer: Cigna Medicaid	$6.41
Rate for Payer: Molina CHIP/Medicaid	$6.41
Rate for Payer: Parkland Medicaid	$6.41
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.41

INPATIENT APRDRG 2321: GASTRIC FUNDOPLICATION

Facility

$1.02

Service Code	APR-DRG 2321
Hospital Charge Code	APRDRG 2321
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Amerigroup CHIP/Medicaid	$1.02
Rate for Payer: Cigna Medicaid	$1.02
Rate for Payer: Molina CHIP/Medicaid	$1.02
Rate for Payer: Parkland Medicaid	$1.02
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.02

INPATIENT APRDRG 2322: GASTRIC FUNDOPLICATION

Facility

$1.40

Service Code	APR-DRG 2322
Hospital Charge Code	APRDRG 2322
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

Know your out-of-pocket cost for care.

All Charges