White Rock Medical Center

All Charges

Charge

Type

Setting

Price

INPATIENT APRDRG 7242: OTHER INFECTIOUS & PARASITIC DISEASES

Facility

$0.76

Service Code	APR-DRG 7242
Hospital Charge Code	APRDRG 7242
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$0.76
Rate for Payer: Amerigroup CHIP/Medicaid	$0.76
Rate for Payer: Cigna Medicaid	$0.76
Rate for Payer: Molina CHIP/Medicaid	$0.76
Rate for Payer: Parkland Medicaid	$0.76
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.76

INPATIENT APRDRG 7243: OTHER INFECTIOUS & PARASITIC DISEASES

Facility

$1.60

Service Code	APR-DRG 7243
Hospital Charge Code	APRDRG 7243
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 7244: OTHER INFECTIOUS & PARASITIC DISEASES

Facility

$4.24

Service Code	APR-DRG 7244
Hospital Charge Code	APRDRG 7244
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$4.24
Rate for Payer: Amerigroup CHIP/Medicaid	$4.24
Rate for Payer: Cigna Medicaid	$4.24
Rate for Payer: Molina CHIP/Medicaid	$4.24
Rate for Payer: Parkland Medicaid	$4.24
Rate for Payer: Superior Health Plan CHIP/Medicaid	$4.24

INPATIENT APRDRG 7401: MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE

Facility

$1.96

Service Code	APR-DRG 7401
Hospital Charge Code	APRDRG 7401
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 7402: MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE

Facility

$2.02

Service Code	APR-DRG 7402
Hospital Charge Code	APRDRG 7402
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Amerigroup CHIP/Medicaid	$2.02
Rate for Payer: Cigna Medicaid	$2.02
Rate for Payer: Molina CHIP/Medicaid	$2.02
Rate for Payer: Parkland Medicaid	$2.02
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.02

INPATIENT APRDRG 7403: MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE

Facility

$3.95

Service Code	APR-DRG 7403
Hospital Charge Code	APRDRG 7403
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$3.95
Rate for Payer: Amerigroup CHIP/Medicaid	$3.95
Rate for Payer: Cigna Medicaid	$3.95
Rate for Payer: Molina CHIP/Medicaid	$3.95
Rate for Payer: Parkland Medicaid	$3.95
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.95

INPATIENT APRDRG 7404: MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE

Facility

$6.96

Service Code	APR-DRG 7404
Hospital Charge Code	APRDRG 7404
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$6.96
Rate for Payer: Amerigroup CHIP/Medicaid	$6.96
Rate for Payer: Cigna Medicaid	$6.96
Rate for Payer: Molina CHIP/Medicaid	$6.96
Rate for Payer: Parkland Medicaid	$6.96
Rate for Payer: Superior Health Plan CHIP/Medicaid	$6.96

INPATIENT APRDRG 7501: SCHIZOPHRENIA

Facility

$0.55

Service Code	APR-DRG 7501
Hospital Charge Code	APRDRG 7501
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$0.55
Rate for Payer: Amerigroup CHIP/Medicaid	$0.55
Rate for Payer: Cigna Medicaid	$0.55
Rate for Payer: Molina CHIP/Medicaid	$0.55
Rate for Payer: Parkland Medicaid	$0.55
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.55

INPATIENT APRDRG 7502: SCHIZOPHRENIA

Facility

$0.64

Service Code	APR-DRG 7502
Hospital Charge Code	APRDRG 7502
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 7503: SCHIZOPHRENIA

Facility

$0.98

Service Code	APR-DRG 7503
Hospital Charge Code	APRDRG 7503
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Amerigroup CHIP/Medicaid	$0.98
Rate for Payer: Cigna Medicaid	$0.98
Rate for Payer: Molina CHIP/Medicaid	$0.98
Rate for Payer: Parkland Medicaid	$0.98
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.98

INPATIENT APRDRG 7504: SCHIZOPHRENIA

Facility

$3.47

Service Code	APR-DRG 7504
Hospital Charge Code	APRDRG 7504
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$3.47
Rate for Payer: Amerigroup CHIP/Medicaid	$3.47
Rate for Payer: Cigna Medicaid	$3.47
Rate for Payer: Molina CHIP/Medicaid	$3.47
Rate for Payer: Parkland Medicaid	$3.47
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.47

INPATIENT APRDRG 7511: MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES

Facility

$0.40

Service Code	APR-DRG 7511
Hospital Charge Code	APRDRG 7511
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.40
Rate for Payer: Amerigroup CHIP/Medicaid	$0.40
Rate for Payer: Cigna Medicaid	$0.40
Rate for Payer: Molina CHIP/Medicaid	$0.40
Rate for Payer: Parkland Medicaid	$0.40
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.40

INPATIENT APRDRG 7512: MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES

Facility

$0.48

Service Code	APR-DRG 7512
Hospital Charge Code	APRDRG 7512
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Amerigroup CHIP/Medicaid	$0.48
Rate for Payer: Cigna Medicaid	$0.48
Rate for Payer: Molina CHIP/Medicaid	$0.48
Rate for Payer: Parkland Medicaid	$0.48
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.48

INPATIENT APRDRG 7513: MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES

Facility

$0.75

Service Code	APR-DRG 7513
Hospital Charge Code	APRDRG 7513
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Amerigroup CHIP/Medicaid	$0.75
Rate for Payer: Cigna Medicaid	$0.75
Rate for Payer: Molina CHIP/Medicaid	$0.75
Rate for Payer: Parkland Medicaid	$0.75
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.75

INPATIENT APRDRG 7514: MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES

Facility

$1.03

Service Code	APR-DRG 7514
Hospital Charge Code	APRDRG 7514
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Amerigroup CHIP/Medicaid	$1.03
Rate for Payer: Cigna Medicaid	$1.03
Rate for Payer: Molina CHIP/Medicaid	$1.03
Rate for Payer: Parkland Medicaid	$1.03
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.03

INPATIENT APRDRG 7521: DISORDERS OF PERSONALITY & IMPULSE CONTROL

Facility

$0.46

Service Code	APR-DRG 7521
Hospital Charge Code	APRDRG 7521
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.46
Rate for Payer: Amerigroup CHIP/Medicaid	$0.46
Rate for Payer: Cigna Medicaid	$0.46
Rate for Payer: Molina CHIP/Medicaid	$0.46
Rate for Payer: Parkland Medicaid	$0.46
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.46

INPATIENT APRDRG 7522: DISORDERS OF PERSONALITY & IMPULSE CONTROL

Facility

$0.55

Service Code	APR-DRG 7522
Hospital Charge Code	APRDRG 7522
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$0.55
Rate for Payer: Amerigroup CHIP/Medicaid	$0.55
Rate for Payer: Cigna Medicaid	$0.55
Rate for Payer: Molina CHIP/Medicaid	$0.55
Rate for Payer: Parkland Medicaid	$0.55
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.55

INPATIENT APRDRG 7523: DISORDERS OF PERSONALITY & IMPULSE CONTROL

Facility

$1.35

Service Code	APR-DRG 7523
Hospital Charge Code	APRDRG 7523
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Amerigroup CHIP/Medicaid	$1.35
Rate for Payer: Cigna Medicaid	$1.35
Rate for Payer: Molina CHIP/Medicaid	$1.35
Rate for Payer: Parkland Medicaid	$1.35
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.35

INPATIENT APRDRG 7524: DISORDERS OF PERSONALITY & IMPULSE CONTROL

Facility

$3.70

Service Code	APR-DRG 7524
Hospital Charge Code	APRDRG 7524
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$3.70
Rate for Payer: Amerigroup CHIP/Medicaid	$3.70
Rate for Payer: Cigna Medicaid	$3.70
Rate for Payer: Molina CHIP/Medicaid	$3.70
Rate for Payer: Parkland Medicaid	$3.70
Rate for Payer: Superior Health Plan CHIP/Medicaid	$3.70

INPATIENT APRDRG 7531: BIPOLAR DISORDERS

Facility

$0.48

Service Code	APR-DRG 7531
Hospital Charge Code	APRDRG 7531
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Amerigroup CHIP/Medicaid	$0.48
Rate for Payer: Cigna Medicaid	$0.48
Rate for Payer: Molina CHIP/Medicaid	$0.48
Rate for Payer: Parkland Medicaid	$0.48
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.48

INPATIENT APRDRG 7532: BIPOLAR DISORDERS

Facility

$0.60

Service Code	APR-DRG 7532
Hospital Charge Code	APRDRG 7532
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 7533: BIPOLAR DISORDERS

Facility

$1.20

Service Code	APR-DRG 7533
Hospital Charge Code	APRDRG 7533
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Amerigroup CHIP/Medicaid	$1.20
Rate for Payer: Cigna Medicaid	$1.20
Rate for Payer: Molina CHIP/Medicaid	$1.20
Rate for Payer: Parkland Medicaid	$1.20
Rate for Payer: Superior Health Plan CHIP/Medicaid	$1.20

INPATIENT APRDRG 7534: BIPOLAR DISORDERS

Facility

$2.76

Service Code	APR-DRG 7534
Hospital Charge Code	APRDRG 7534
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$2.76
Rate for Payer: Amerigroup CHIP/Medicaid	$2.76
Rate for Payer: Cigna Medicaid	$2.76
Rate for Payer: Molina CHIP/Medicaid	$2.76
Rate for Payer: Parkland Medicaid	$2.76
Rate for Payer: Superior Health Plan CHIP/Medicaid	$2.76

INPATIENT APRDRG 7541: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$0.34

Service Code	APR-DRG 7541
Hospital Charge Code	APRDRG 7541
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Amerigroup CHIP/Medicaid	$0.34
Rate for Payer: Cigna Medicaid	$0.34
Rate for Payer: Molina CHIP/Medicaid	$0.34
Rate for Payer: Parkland Medicaid	$0.34
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.34

INPATIENT APRDRG 7542: DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER

Facility

$0.47

Service Code	APR-DRG 7542
Hospital Charge Code	APRDRG 7542
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$0.47
Rate for Payer: Amerigroup CHIP/Medicaid	$0.47
Rate for Payer: Cigna Medicaid	$0.47
Rate for Payer: Molina CHIP/Medicaid	$0.47
Rate for Payer: Parkland Medicaid	$0.47
Rate for Payer: Superior Health Plan CHIP/Medicaid	$0.47

Know your out-of-pocket cost for care.

All Charges