White Rock Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 7101: INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE

Facility

$1.33

Service Code	APR-DRG 7101
Hospital Charge Code	APRDRG 7101
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Amerigroup CHIP/Medicaid	$1.33
Rate for Payer: Cigna Medicaid	$1.33
Rate for Payer: Molina CHIP/Medicaid	$1.33
Rate for Payer: Parkland Medicaid	$1.33
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.33

INPATIENT APRDRG 7102: INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE

Facility

$1.91

Service Code	APR-DRG 7102
Hospital Charge Code	APRDRG 7102
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$1.91
Rate for Payer: Amerigroup CHIP/Medicaid	$1.91
Rate for Payer: Cigna Medicaid	$1.91
Rate for Payer: Molina CHIP/Medicaid	$1.91
Rate for Payer: Parkland Medicaid	$1.91
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.91

INPATIENT APRDRG 7103: INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE

Facility

$3.32

Service Code	APR-DRG 7103
Hospital Charge Code	APRDRG 7103
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$3.32
Rate for Payer: Amerigroup CHIP/Medicaid	$3.32
Rate for Payer: Cigna Medicaid	$3.32
Rate for Payer: Molina CHIP/Medicaid	$3.32
Rate for Payer: Parkland Medicaid	$3.32
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.32

INPATIENT APRDRG 7104: INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE

Facility

$8.04

Service Code	APR-DRG 7104
Hospital Charge Code	APRDRG 7104
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$8.04
Rate for Payer: Amerigroup CHIP/Medicaid	$8.04
Rate for Payer: Cigna Medicaid	$8.04
Rate for Payer: Molina CHIP/Medicaid	$8.04
Rate for Payer: Parkland Medicaid	$8.04
Rate for Payer: Superior Health Plan CHIP/Medicaid	$8.04

INPATIENT APRDRG 7111: POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE

Facility

$1.58

Service Code	APR-DRG 7111
Hospital Charge Code	APRDRG 7111
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1.58
Rate for Payer: Amerigroup CHIP/Medicaid	$1.58
Rate for Payer: Cigna Medicaid	$1.58
Rate for Payer: Molina CHIP/Medicaid	$1.58
Rate for Payer: Parkland Medicaid	$1.58
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.58

INPATIENT APRDRG 7112: POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE

Facility

$2.03

Service Code	APR-DRG 7112
Hospital Charge Code	APRDRG 7112
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$2.03
Rate for Payer: Amerigroup CHIP/Medicaid	$2.03
Rate for Payer: Cigna Medicaid	$2.03
Rate for Payer: Molina CHIP/Medicaid	$2.03
Rate for Payer: Parkland Medicaid	$2.03
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.03

INPATIENT APRDRG 7113: POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE

Facility

$3.75

Service Code	APR-DRG 7113
Hospital Charge Code	APRDRG 7113
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Amerigroup CHIP/Medicaid	$3.75
Rate for Payer: Cigna Medicaid	$3.75
Rate for Payer: Molina CHIP/Medicaid	$3.75
Rate for Payer: Parkland Medicaid	$3.75
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.75

INPATIENT APRDRG 7114: POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE

Facility

$6.75

Service Code	APR-DRG 7114
Hospital Charge Code	APRDRG 7114
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Amerigroup CHIP/Medicaid	$6.75
Rate for Payer: Cigna Medicaid	$6.75
Rate for Payer: Molina CHIP/Medicaid	$6.75
Rate for Payer: Parkland Medicaid	$6.75
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.75

INPATIENT APRDRG 7201: SEPTICEMIA & DISSEMINATED INFECTIONS

Facility

$0.64

Service Code	APR-DRG 7201
Hospital Charge Code	APRDRG 7201
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 7202: SEPTICEMIA & DISSEMINATED INFECTIONS

Facility

$0.92

Service Code	APR-DRG 7202
Hospital Charge Code	APRDRG 7202
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Amerigroup CHIP/Medicaid	$0.92
Rate for Payer: Cigna Medicaid	$0.92
Rate for Payer: Molina CHIP/Medicaid	$0.92
Rate for Payer: Parkland Medicaid	$0.92
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.92

INPATIENT APRDRG 7203: SEPTICEMIA & DISSEMINATED INFECTIONS

Facility

$1.54

Service Code	APR-DRG 7203
Hospital Charge Code	APRDRG 7203
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 7204: SEPTICEMIA & DISSEMINATED INFECTIONS

Facility

$3.75

Service Code	APR-DRG 7204
Hospital Charge Code	APRDRG 7204
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Amerigroup CHIP/Medicaid	$3.75
Rate for Payer: Cigna Medicaid	$3.75
Rate for Payer: Molina CHIP/Medicaid	$3.75
Rate for Payer: Parkland Medicaid	$3.75
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.75

INPATIENT APRDRG 7211: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS

Facility

$0.77

Service Code	APR-DRG 7211
Hospital Charge Code	APRDRG 7211
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 7212: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS

Facility

$1.10

Service Code	APR-DRG 7212
Hospital Charge Code	APRDRG 7212
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Amerigroup CHIP/Medicaid	$1.10
Rate for Payer: Cigna Medicaid	$1.10
Rate for Payer: Molina CHIP/Medicaid	$1.10
Rate for Payer: Parkland Medicaid	$1.10
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.10

INPATIENT APRDRG 7213: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS

Facility

$1.93

Service Code	APR-DRG 7213
Hospital Charge Code	APRDRG 7213
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 7214: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS

Facility

$3.88

Service Code	APR-DRG 7214
Hospital Charge Code	APRDRG 7214
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$3.88
Rate for Payer: Amerigroup CHIP/Medicaid	$3.88
Rate for Payer: Cigna Medicaid	$3.88
Rate for Payer: Molina CHIP/Medicaid	$3.88
Rate for Payer: Parkland Medicaid	$3.88
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.88

INPATIENT APRDRG 7221: FEVER

Facility

$0.39

Service Code	APR-DRG 7221
Hospital Charge Code	APRDRG 7221
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Amerigroup CHIP/Medicaid	$0.39
Rate for Payer: Cigna Medicaid	$0.39
Rate for Payer: Molina CHIP/Medicaid	$0.39
Rate for Payer: Parkland Medicaid	$0.39
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.39

INPATIENT APRDRG 7222: FEVER

Facility

$0.58

Service Code	APR-DRG 7222
Hospital Charge Code	APRDRG 7222
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Amerigroup CHIP/Medicaid	$0.58
Rate for Payer: Cigna Medicaid	$0.58
Rate for Payer: Molina CHIP/Medicaid	$0.58
Rate for Payer: Parkland Medicaid	$0.58
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.58

INPATIENT APRDRG 7223: FEVER

Facility

$1.02

Service Code	APR-DRG 7223
Hospital Charge Code	APRDRG 7223
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 7224: FEVER

Facility

$1.29

Service Code	APR-DRG 7224
Hospital Charge Code	APRDRG 7224
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Amerigroup CHIP/Medicaid	$1.29
Rate for Payer: Cigna Medicaid	$1.29
Rate for Payer: Molina CHIP/Medicaid	$1.29
Rate for Payer: Parkland Medicaid	$1.29
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.29

INPATIENT APRDRG 7231: VIRAL ILLNESS

Facility

$0.44

Service Code	APR-DRG 7231
Hospital Charge Code	APRDRG 7231
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.44
Rate for Payer: Amerigroup CHIP/Medicaid	$0.44
Rate for Payer: Cigna Medicaid	$0.44
Rate for Payer: Molina CHIP/Medicaid	$0.44
Rate for Payer: Parkland Medicaid	$0.44
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.44

INPATIENT APRDRG 7232: VIRAL ILLNESS

Facility

$0.63

Service Code	APR-DRG 7232
Hospital Charge Code	APRDRG 7232
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 7233: VIRAL ILLNESS

Facility

$1.32

Service Code	APR-DRG 7233
Hospital Charge Code	APRDRG 7233
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 7234: VIRAL ILLNESS

Facility

$7.71

Service Code	APR-DRG 7234
Hospital Charge Code	APRDRG 7234
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$7.71
Rate for Payer: Amerigroup CHIP/Medicaid	$7.71
Rate for Payer: Cigna Medicaid	$7.71
Rate for Payer: Molina CHIP/Medicaid	$7.71
Rate for Payer: Parkland Medicaid	$7.71
Rate for Payer: Superior Health Plan CHIP/Medicaid	$7.71

INPATIENT APRDRG 7241: OTHER INFECTIOUS & PARASITIC DISEASES

Facility

$0.65

Service Code	APR-DRG 7241
Hospital Charge Code	APRDRG 7241
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

Know your out-of-pocket cost for care.

All Charges