White Rock Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 3841: CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE

Facility

$0.64

Service Code	APR-DRG 3841
Hospital Charge Code	APRDRG 3841
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 3842: CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE

Facility

$1.04

Service Code	APR-DRG 3842
Hospital Charge Code	APRDRG 3842
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Amerigroup CHIP/Medicaid	$1.04
Rate for Payer: Cigna Medicaid	$1.04
Rate for Payer: Molina CHIP/Medicaid	$1.04
Rate for Payer: Parkland Medicaid	$1.04
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.04

INPATIENT APRDRG 3843: CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE

Facility

$1.57

Service Code	APR-DRG 3843
Hospital Charge Code	APRDRG 3843
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 3844: CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE

Facility

$4.86

Service Code	APR-DRG 3844
Hospital Charge Code	APRDRG 3844
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$4.86
Rate for Payer: Amerigroup CHIP/Medicaid	$4.86
Rate for Payer: Cigna Medicaid	$4.86
Rate for Payer: Molina CHIP/Medicaid	$4.86
Rate for Payer: Parkland Medicaid	$4.86
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.86

INPATIENT APRDRG 3851: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility

$0.52

Service Code	APR-DRG 3851
Hospital Charge Code	APRDRG 3851
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$0.52
Rate for Payer: Amerigroup CHIP/Medicaid	$0.52
Rate for Payer: Cigna Medicaid	$0.52
Rate for Payer: Molina CHIP/Medicaid	$0.52
Rate for Payer: Parkland Medicaid	$0.52
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.52

INPATIENT APRDRG 3852: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility

$0.89

Service Code	APR-DRG 3852
Hospital Charge Code	APRDRG 3852
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 3853: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility

$1.93

Service Code	APR-DRG 3853
Hospital Charge Code	APRDRG 3853
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$1.93
Rate for Payer: Amerigroup CHIP/Medicaid	$1.93
Rate for Payer: Cigna Medicaid	$1.93
Rate for Payer: Molina CHIP/Medicaid	$1.93
Rate for Payer: Parkland Medicaid	$1.93
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.93

INPATIENT APRDRG 3854: OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS

Facility

$3.69

Service Code	APR-DRG 3854
Hospital Charge Code	APRDRG 3854
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$3.69
Rate for Payer: Amerigroup CHIP/Medicaid	$3.69
Rate for Payer: Cigna Medicaid	$3.69
Rate for Payer: Molina CHIP/Medicaid	$3.69
Rate for Payer: Parkland Medicaid	$3.69
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.69

INPATIENT APRDRG 4011: ADRENAL PROCEDURES

Facility

$1.98

Service Code	APR-DRG 4011
Hospital Charge Code	APRDRG 4011
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Amerigroup CHIP/Medicaid	$1.98
Rate for Payer: Cigna Medicaid	$1.98
Rate for Payer: Molina CHIP/Medicaid	$1.98
Rate for Payer: Parkland Medicaid	$1.98
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.98

INPATIENT APRDRG 4012: ADRENAL PROCEDURES

Facility

$5.91

Service Code	APR-DRG 4012
Hospital Charge Code	APRDRG 4012
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$5.91
Rate for Payer: Amerigroup CHIP/Medicaid	$5.91
Rate for Payer: Cigna Medicaid	$5.91
Rate for Payer: Molina CHIP/Medicaid	$5.91
Rate for Payer: Parkland Medicaid	$5.91
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.91

INPATIENT APRDRG 4013: ADRENAL PROCEDURES

Facility

$6.94

Service Code	APR-DRG 4013
Hospital Charge Code	APRDRG 4013
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Amerigroup CHIP/Medicaid	$6.94
Rate for Payer: Cigna Medicaid	$6.94
Rate for Payer: Molina CHIP/Medicaid	$6.94
Rate for Payer: Parkland Medicaid	$6.94
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.94

INPATIENT APRDRG 4014: ADRENAL PROCEDURES

Facility

$6.20

Service Code	APR-DRG 4014
Hospital Charge Code	APRDRG 4014
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$6.20
Rate for Payer: Amerigroup CHIP/Medicaid	$6.20
Rate for Payer: Cigna Medicaid	$6.20
Rate for Payer: Molina CHIP/Medicaid	$6.20
Rate for Payer: Parkland Medicaid	$6.20
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.20

INPATIENT APRDRG 4031: PROCEDURES FOR OBESITY

Facility

$1.39

Service Code	APR-DRG 4031
Hospital Charge Code	APRDRG 4031
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.39
Rate for Payer: Amerigroup CHIP/Medicaid	$1.39
Rate for Payer: Cigna Medicaid	$1.39
Rate for Payer: Molina CHIP/Medicaid	$1.39
Rate for Payer: Parkland Medicaid	$1.39
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.39

INPATIENT APRDRG 4032: PROCEDURES FOR OBESITY

Facility

$1.57

Service Code	APR-DRG 4032
Hospital Charge Code	APRDRG 4032
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 4033: PROCEDURES FOR OBESITY

Facility

$2.67

Service Code	APR-DRG 4033
Hospital Charge Code	APRDRG 4033
Min. Negotiated Rate	$2.67
Max. Negotiated Rate	$2.67
Rate for Payer: Amerigroup CHIP/Medicaid	$2.67
Rate for Payer: Cigna Medicaid	$2.67
Rate for Payer: Molina CHIP/Medicaid	$2.67
Rate for Payer: Parkland Medicaid	$2.67
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.67

INPATIENT APRDRG 4034: PROCEDURES FOR OBESITY

Facility

$3.31

Service Code	APR-DRG 4034
Hospital Charge Code	APRDRG 4034
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$3.31
Rate for Payer: Amerigroup CHIP/Medicaid	$3.31
Rate for Payer: Cigna Medicaid	$3.31
Rate for Payer: Molina CHIP/Medicaid	$3.31
Rate for Payer: Parkland Medicaid	$3.31
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.31

INPATIENT APRDRG 4041: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility

$1.60

Service Code	APR-DRG 4041
Hospital Charge Code	APRDRG 4041
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$1.60
Rate for Payer: Amerigroup CHIP/Medicaid	$1.60
Rate for Payer: Cigna Medicaid	$1.60
Rate for Payer: Molina CHIP/Medicaid	$1.60
Rate for Payer: Parkland Medicaid	$1.60
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.60

INPATIENT APRDRG 4042: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility

$2.18

Service Code	APR-DRG 4042
Hospital Charge Code	APRDRG 4042
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$2.18
Rate for Payer: Amerigroup CHIP/Medicaid	$2.18
Rate for Payer: Cigna Medicaid	$2.18
Rate for Payer: Molina CHIP/Medicaid	$2.18
Rate for Payer: Parkland Medicaid	$2.18
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.18

INPATIENT APRDRG 4043: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility

$5.09

Service Code	APR-DRG 4043
Hospital Charge Code	APRDRG 4043
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$5.09
Rate for Payer: Amerigroup CHIP/Medicaid	$5.09
Rate for Payer: Cigna Medicaid	$5.09
Rate for Payer: Molina CHIP/Medicaid	$5.09
Rate for Payer: Parkland Medicaid	$5.09
Rate for Payer: Superior Health Plan CHIP/Medicaid	$5.09

INPATIENT APRDRG 4044: THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES

Facility

$6.69

Service Code	APR-DRG 4044
Hospital Charge Code	APRDRG 4044
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$6.69
Rate for Payer: Amerigroup CHIP/Medicaid	$6.69
Rate for Payer: Cigna Medicaid	$6.69
Rate for Payer: Molina CHIP/Medicaid	$6.69
Rate for Payer: Parkland Medicaid	$6.69
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.69

INPATIENT APRDRG 4051: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility

$2.51

Service Code	APR-DRG 4051
Hospital Charge Code	APRDRG 4051
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$2.51
Rate for Payer: Amerigroup CHIP/Medicaid	$2.51
Rate for Payer: Cigna Medicaid	$2.51
Rate for Payer: Molina CHIP/Medicaid	$2.51
Rate for Payer: Parkland Medicaid	$2.51
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.51

INPATIENT APRDRG 4052: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility

$2.96

Service Code	APR-DRG 4052
Hospital Charge Code	APRDRG 4052
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$2.96
Rate for Payer: Amerigroup CHIP/Medicaid	$2.96
Rate for Payer: Cigna Medicaid	$2.96
Rate for Payer: Molina CHIP/Medicaid	$2.96
Rate for Payer: Parkland Medicaid	$2.96
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.96

INPATIENT APRDRG 4053: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility

$3.40

Service Code	APR-DRG 4053
Hospital Charge Code	APRDRG 4053
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$3.40
Rate for Payer: Amerigroup CHIP/Medicaid	$3.40
Rate for Payer: Cigna Medicaid	$3.40
Rate for Payer: Molina CHIP/Medicaid	$3.40
Rate for Payer: Parkland Medicaid	$3.40
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.40

INPATIENT APRDRG 4054: OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL & METABOLIC DISORDERS

Facility

$6.23

Service Code	APR-DRG 4054
Hospital Charge Code	APRDRG 4054
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$6.23
Rate for Payer: Amerigroup CHIP/Medicaid	$6.23
Rate for Payer: Cigna Medicaid	$6.23
Rate for Payer: Molina CHIP/Medicaid	$6.23
Rate for Payer: Parkland Medicaid	$6.23
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.23

INPATIENT APRDRG 4201: DIABETES

Facility

$0.57

Service Code	APR-DRG 4201
Hospital Charge Code	APRDRG 4201
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$0.57
Rate for Payer: Amerigroup CHIP/Medicaid	$0.57
Rate for Payer: Cigna Medicaid	$0.57
Rate for Payer: Molina CHIP/Medicaid	$0.57
Rate for Payer: Parkland Medicaid	$0.57
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.57

Know your out-of-pocket cost for care.

All Charges