White Rock Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 2632: CHOLECYSTECTOMY

Facility

$1.57

Service Code	APR-DRG 2632
Hospital Charge Code	APRDRG 2632
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Amerigroup CHIP/Medicaid	$1.57
Rate for Payer: Cigna Medicaid	$1.57
Rate for Payer: Molina CHIP/Medicaid	$1.57
Rate for Payer: Parkland Medicaid	$1.57
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.57

INPATIENT APRDRG 2633: CHOLECYSTECTOMY

Facility

$2.00

Service Code	APR-DRG 2633
Hospital Charge Code	APRDRG 2633
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$2.00
Rate for Payer: Amerigroup CHIP/Medicaid	$2.00
Rate for Payer: Cigna Medicaid	$2.00
Rate for Payer: Molina CHIP/Medicaid	$2.00
Rate for Payer: Parkland Medicaid	$2.00
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.00

INPATIENT APRDRG 2634: CHOLECYSTECTOMY

Facility

$5.52

Service Code	APR-DRG 2634
Hospital Charge Code	APRDRG 2634
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$5.52
Rate for Payer: Amerigroup CHIP/Medicaid	$5.52
Rate for Payer: Cigna Medicaid	$5.52
Rate for Payer: Molina CHIP/Medicaid	$5.52
Rate for Payer: Parkland Medicaid	$5.52
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.52

INPATIENT APRDRG 2641: OTHER HEPATOBILIARY, PANCREAS & ABDOMINAL PROCEDURES

Facility

$2.39

Service Code	APR-DRG 2641
Hospital Charge Code	APRDRG 2641
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$2.39
Rate for Payer: Amerigroup CHIP/Medicaid	$2.39
Rate for Payer: Cigna Medicaid	$2.39
Rate for Payer: Molina CHIP/Medicaid	$2.39
Rate for Payer: Parkland Medicaid	$2.39
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.39

INPATIENT APRDRG 2642: OTHER HEPATOBILIARY, PANCREAS & ABDOMINAL PROCEDURES

Facility

$3.05

Service Code	APR-DRG 2642
Hospital Charge Code	APRDRG 2642
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$3.05
Rate for Payer: Amerigroup CHIP/Medicaid	$3.05
Rate for Payer: Cigna Medicaid	$3.05
Rate for Payer: Molina CHIP/Medicaid	$3.05
Rate for Payer: Parkland Medicaid	$3.05
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.05

INPATIENT APRDRG 2643: OTHER HEPATOBILIARY, PANCREAS & ABDOMINAL PROCEDURES

Facility

$3.71

Service Code	APR-DRG 2643
Hospital Charge Code	APRDRG 2643
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$3.71
Rate for Payer: Amerigroup CHIP/Medicaid	$3.71
Rate for Payer: Cigna Medicaid	$3.71
Rate for Payer: Molina CHIP/Medicaid	$3.71
Rate for Payer: Parkland Medicaid	$3.71
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.71

INPATIENT APRDRG 2644: OTHER HEPATOBILIARY, PANCREAS & ABDOMINAL PROCEDURES

Facility

$7.07

Service Code	APR-DRG 2644
Hospital Charge Code	APRDRG 2644
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$7.07
Rate for Payer: Amerigroup CHIP/Medicaid	$7.07
Rate for Payer: Cigna Medicaid	$7.07
Rate for Payer: Molina CHIP/Medicaid	$7.07
Rate for Payer: Parkland Medicaid	$7.07
Rate for Payer: Superior Health Plan CHIP/Medicaid	$7.07

INPATIENT APRDRG 2791: HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$0.60

Service Code	APR-DRG 2791
Hospital Charge Code	APRDRG 2791
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 2792: HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$0.89

Service Code	APR-DRG 2792
Hospital Charge Code	APRDRG 2792
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Amerigroup CHIP/Medicaid	$0.89
Rate for Payer: Cigna Medicaid	$0.89
Rate for Payer: Molina CHIP/Medicaid	$0.89
Rate for Payer: Parkland Medicaid	$0.89
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.89

INPATIENT APRDRG 2793: HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$1.22

Service Code	APR-DRG 2793
Hospital Charge Code	APRDRG 2793
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Amerigroup CHIP/Medicaid	$1.22
Rate for Payer: Cigna Medicaid	$1.22
Rate for Payer: Molina CHIP/Medicaid	$1.22
Rate for Payer: Parkland Medicaid	$1.22
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.22

INPATIENT APRDRG 2794: HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$3.55

Service Code	APR-DRG 2794
Hospital Charge Code	APRDRG 2794
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 2801: ALCOHOLIC LIVER DISEASE

Facility

$0.62

Service Code	APR-DRG 2801
Hospital Charge Code	APRDRG 2801
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 2802: ALCOHOLIC LIVER DISEASE

Facility

$0.82

Service Code	APR-DRG 2802
Hospital Charge Code	APRDRG 2802
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.82
Rate for Payer: Amerigroup CHIP/Medicaid	$0.82
Rate for Payer: Cigna Medicaid	$0.82
Rate for Payer: Molina CHIP/Medicaid	$0.82
Rate for Payer: Parkland Medicaid	$0.82
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.82

INPATIENT APRDRG 2803: ALCOHOLIC LIVER DISEASE

Facility

$1.28

Service Code	APR-DRG 2803
Hospital Charge Code	APRDRG 2803
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Amerigroup CHIP/Medicaid	$1.28
Rate for Payer: Cigna Medicaid	$1.28
Rate for Payer: Molina CHIP/Medicaid	$1.28
Rate for Payer: Parkland Medicaid	$1.28
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.28

INPATIENT APRDRG 2804: ALCOHOLIC LIVER DISEASE

Facility

$3.25

Service Code	APR-DRG 2804
Hospital Charge Code	APRDRG 2804
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$3.25
Rate for Payer: Amerigroup CHIP/Medicaid	$3.25
Rate for Payer: Cigna Medicaid	$3.25
Rate for Payer: Molina CHIP/Medicaid	$3.25
Rate for Payer: Parkland Medicaid	$3.25
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.25

INPATIENT APRDRG 2811: MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$1.02

Service Code	APR-DRG 2811
Hospital Charge Code	APRDRG 2811
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 2812: MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$1.16

Service Code	APR-DRG 2812
Hospital Charge Code	APRDRG 2812
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Amerigroup CHIP/Medicaid	$1.16
Rate for Payer: Cigna Medicaid	$1.16
Rate for Payer: Molina CHIP/Medicaid	$1.16
Rate for Payer: Parkland Medicaid	$1.16
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.16

INPATIENT APRDRG 2813: MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$1.53

Service Code	APR-DRG 2813
Hospital Charge Code	APRDRG 2813
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$1.53
Rate for Payer: Amerigroup CHIP/Medicaid	$1.53
Rate for Payer: Cigna Medicaid	$1.53
Rate for Payer: Molina CHIP/Medicaid	$1.53
Rate for Payer: Parkland Medicaid	$1.53
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.53

INPATIENT APRDRG 2814: MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS

Facility

$2.30

Service Code	APR-DRG 2814
Hospital Charge Code	APRDRG 2814
Min. Negotiated Rate	$2.30
Max. Negotiated Rate	$2.30
Rate for Payer: Amerigroup CHIP/Medicaid	$2.30
Rate for Payer: Cigna Medicaid	$2.30
Rate for Payer: Molina CHIP/Medicaid	$2.30
Rate for Payer: Parkland Medicaid	$2.30
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.30

INPATIENT APRDRG 2821: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$0.67

Service Code	APR-DRG 2821
Hospital Charge Code	APRDRG 2821
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Amerigroup CHIP/Medicaid	$0.67
Rate for Payer: Cigna Medicaid	$0.67
Rate for Payer: Molina CHIP/Medicaid	$0.67
Rate for Payer: Parkland Medicaid	$0.67
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.67

INPATIENT APRDRG 2822: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$0.93

Service Code	APR-DRG 2822
Hospital Charge Code	APRDRG 2822
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 2823: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$1.57

Service Code	APR-DRG 2823
Hospital Charge Code	APRDRG 2823
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Amerigroup CHIP/Medicaid	$1.57
Rate for Payer: Cigna Medicaid	$1.57
Rate for Payer: Molina CHIP/Medicaid	$1.57
Rate for Payer: Parkland Medicaid	$1.57
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.57

INPATIENT APRDRG 2824: DISORDERS OF PANCREAS EXCEPT MALIGNANCY

Facility

$5.56

Service Code	APR-DRG 2824
Hospital Charge Code	APRDRG 2824
Min. Negotiated Rate	$5.56
Max. Negotiated Rate	$5.56
Rate for Payer: Amerigroup CHIP/Medicaid	$5.56
Rate for Payer: Cigna Medicaid	$5.56
Rate for Payer: Molina CHIP/Medicaid	$5.56
Rate for Payer: Parkland Medicaid	$5.56
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.56

INPATIENT APRDRG 2831: OTHER DISORDERS OF THE LIVER

Facility

$0.63

Service Code	APR-DRG 2831
Hospital Charge Code	APRDRG 2831
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$0.63
Rate for Payer: Amerigroup CHIP/Medicaid	$0.63
Rate for Payer: Cigna Medicaid	$0.63
Rate for Payer: Molina CHIP/Medicaid	$0.63
Rate for Payer: Parkland Medicaid	$0.63
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.63

INPATIENT APRDRG 2832: OTHER DISORDERS OF THE LIVER

Facility

$0.89

Service Code	APR-DRG 2832
Hospital Charge Code	APRDRG 2832
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Amerigroup CHIP/Medicaid	$0.89
Rate for Payer: Cigna Medicaid	$0.89
Rate for Payer: Molina CHIP/Medicaid	$0.89
Rate for Payer: Parkland Medicaid	$0.89
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.89

Know your out-of-pocket cost for care.

All Charges