hospital_Lakeland Behavioral Health System last_updated_ 2023-12-31 version_1 "hospital_Springfield, Missouri" hospital_address 440 S Market Ave. license_ 432-26 | MI "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded in this machine-readable file is true, accurate, and complete as of the date indicated in this file" description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AETNA MERCY MCR|MANAGED MEDICARE] standard_charge|[payer_AETNA MERCY MCR|MANAGED MEDICARE] |percent standard_charge|[payer_AETNA MERCY MCR|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA MERCY MCR|MANAGED MEDICARE] standard_charge|[payer_AETNA MERCY STJ CLMS|HMO/PPO] standard_charge|[payer_AETNA MERCY STJ CLMS|HMO/PPO] |percent standard_charge|[payer_AETNA MERCY STJ CLMS|HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA MERCY STJ CLMS|HMO/PPO] standard_charge|[payer_ALABAMA CHAMBER CTY DHR|LOCAL GOVT] standard_charge|[payer_ALABAMA CHAMBER CTY DHR|LOCAL GOVT] |percent standard_charge|[payer_ALABAMA CHAMBER CTY DHR|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ALABAMA CHAMBER CTY DHR|LOCAL GOVT] standard_charge|[payer_ALASKA MCD TPL ENTER INS|MEDICAID: CBS OOS] standard_charge|[payer_ALASKA MCD TPL ENTER INS|MEDICAID: CBS OOS] |percent standard_charge|[payer_ALASKA MCD TPL ENTER INS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ALASKA MCD TPL ENTER INS|MEDICAID: CBS OOS] standard_charge|[payer_ALASKA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_ALASKA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_ALASKA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ALASKA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_ALASKA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_ALASKA MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ALASKA MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ALASKA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_AMBETTER CENPATICO|HMO/PPO] standard_charge|[payer_AMBETTER CENPATICO|HMO/PPO] |percent standard_charge|[payer_AMBETTER CENPATICO|HMO/PPO] |contracting_method additional_payer_notes |[payer_AMBETTER CENPATICO|HMO/PPO] standard_charge|[payer_ANTHEM BLUE CROSS|BLUE CROSS] standard_charge|[payer_ANTHEM BLUE CROSS|BLUE CROSS] |percent standard_charge|[payer_ANTHEM BLUE CROSS|BLUE CROSS] |contracting_method additional_payer_notes |[payer_ANTHEM BLUE CROSS|BLUE CROSS] standard_charge|[payer_ANTHEM FEDERAL BC|BLUE CROSS] standard_charge|[payer_ANTHEM FEDERAL BC|BLUE CROSS] |percent standard_charge|[payer_ANTHEM FEDERAL BC|BLUE CROSS] |contracting_method additional_payer_notes |[payer_ANTHEM FEDERAL BC|BLUE CROSS] standard_charge|[payer_ARIZONA BANNER UNI HEALTH|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA BANNER UNI HEALTH|MEDICAID: CBS OOS] |percent standard_charge|[payer_ARIZONA BANNER UNI HEALTH|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ARIZONA BANNER UNI HEALTH|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA BANNER UNI HEALTH|MEDICAID: OUT OF STATE] standard_charge|[payer_ARIZONA BANNER UNI HEALTH|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARIZONA BANNER UNI HEALTH|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARIZONA BANNER UNI HEALTH|MEDICAID: OUT OF STATE] standard_charge|[payer_ARIZONA DCS|LOCAL GOVT] standard_charge|[payer_ARIZONA DCS|LOCAL GOVT] |percent standard_charge|[payer_ARIZONA DCS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ARIZONA DCS|LOCAL GOVT] standard_charge|[payer_ARIZONA HEALTH CHOICE|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA HEALTH CHOICE|MEDICAID: CBS OOS] |percent standard_charge|[payer_ARIZONA HEALTH CHOICE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ARIZONA HEALTH CHOICE|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA HEALTH CHOICE|MEDICAID: OUT OF STATE] standard_charge|[payer_ARIZONA HEALTH CHOICE|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARIZONA HEALTH CHOICE|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARIZONA HEALTH CHOICE|MEDICAID: OUT OF STATE] standard_charge|[payer_ARIZONA MCD TPL ENTER INS|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA MCD TPL ENTER INS|MEDICAID: CBS OOS] |percent standard_charge|[payer_ARIZONA MCD TPL ENTER INS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ARIZONA MCD TPL ENTER INS|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA MERCY CARE MCD|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA MERCY CARE MCD|MEDICAID: CBS OOS] |percent standard_charge|[payer_ARIZONA MERCY CARE MCD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ARIZONA MERCY CARE MCD|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA MERCY CARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_ARIZONA MERCY CARE MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARIZONA MERCY CARE MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARIZONA MERCY CARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MEDICAID: CBS OOS] |percent standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ARIZONA UHC COMMUNITYPLAN|MEDICAID: CBS OOS] standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MEDICAID: OUT OF STATE] standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARIZONA UHC COMMUNITYPLAN|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS CARESOURCE|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS CARESOURCE|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARKANSAS CARESOURCE|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARKANSAS CARESOURCE|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS EMPOWER MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS EMPOWER MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARKANSAS EMPOWER MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARKANSAS EMPOWER MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS MCD TPL ENTERINS|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS MCD TPL ENTERINS|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARKANSAS MCD TPL ENTERINS|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARKANSAS MCD TPL ENTERINS|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARKANSAS MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARKANSAS MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS SUMMIT MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS SUMMIT MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARKANSAS SUMMIT MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARKANSAS SUMMIT MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS TOTAL CARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKANSAS TOTAL CARE MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARKANSAS TOTAL CARE MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARKANSAS TOTAL CARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] |percent standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] |contracting_method additional_payer_notes |[payer_BEACON HEALTH OPTIONS|HMO/PPO] standard_charge|[payer_BENEFITS ADMINISTRATIVE S|COMMERCIAL] standard_charge|[payer_BENEFITS ADMINISTRATIVE S|COMMERCIAL] |percent standard_charge|[payer_BENEFITS ADMINISTRATIVE S|COMMERCIAL] |contracting_method additional_payer_notes |[payer_BENEFITS ADMINISTRATIVE S|COMMERCIAL] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |percent standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] |percent standard_charge|[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_CO EPDST|MEDICAID: CBS OOS] standard_charge|[payer_CO EPDST|MEDICAID: CBS OOS] |percent standard_charge|[payer_CO EPDST|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CO EPDST|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO ACCESS MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO ACCESS MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_COLORADO ACCESS MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_COLORADO ACCESS MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO ACCESS MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_COLORADO ACCESS MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_COLORADO ACCESS MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_COLORADO ACCESS MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_COLORADO BEACON|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO BEACON|MEDICAID: CBS OOS] |percent standard_charge|[payer_COLORADO BEACON|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_COLORADO BEACON|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO CHIP MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO CHIP MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_COLORADO CHIP MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_COLORADO CHIP MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO CHIP MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_COLORADO CHIP MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_COLORADO CHIP MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_COLORADO CHIP MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_COLORADO COMMUNITY HEALTH|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO COMMUNITY HEALTH|MEDICAID: CBS OOS] |percent standard_charge|[payer_COLORADO COMMUNITY HEALTH|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_COLORADO COMMUNITY HEALTH|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO COMMUNITY HEALTH|MEDICAID: OUT OF STATE] standard_charge|[payer_COLORADO COMMUNITY HEALTH|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_COLORADO COMMUNITY HEALTH|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_COLORADO COMMUNITY HEALTH|MEDICAID: OUT OF STATE] standard_charge|[payer_COLORADO EL PASO CTY|LOCAL GOVT] standard_charge|[payer_COLORADO EL PASO CTY|LOCAL GOVT] |percent standard_charge|[payer_COLORADO EL PASO CTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_COLORADO EL PASO CTY|LOCAL GOVT] standard_charge|[payer_COLORADO ROCKY MTN MCD|MEDICAID: CBS OOS] standard_charge|[payer_COLORADO ROCKY MTN MCD|MEDICAID: CBS OOS] |percent standard_charge|[payer_COLORADO ROCKY MTN MCD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_COLORADO ROCKY MTN MCD|MEDICAID: CBS OOS] standard_charge|[payer_COMMERCIAL/ENTER NAME|COMMERCIAL] standard_charge|[payer_COMMERCIAL/ENTER NAME|COMMERCIAL] |percent standard_charge|[payer_COMMERCIAL/ENTER NAME|COMMERCIAL] |contracting_method additional_payer_notes |[payer_COMMERCIAL/ENTER NAME|COMMERCIAL] standard_charge|[payer_COMPSYCH|COMMERCIAL] standard_charge|[payer_COMPSYCH|COMMERCIAL] |percent standard_charge|[payer_COMPSYCH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_COMPSYCH|COMMERCIAL] standard_charge|[payer_COX HEALTH SYSTEMS|COMMERCIAL] standard_charge|[payer_COX HEALTH SYSTEMS|COMMERCIAL] |percent standard_charge|[payer_COX HEALTH SYSTEMS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_COX HEALTH SYSTEMS|COMMERCIAL] standard_charge|[payer_DELAWARE DSCYF|LOCAL GOVT] standard_charge|[payer_DELAWARE DSCYF|LOCAL GOVT] |percent standard_charge|[payer_DELAWARE DSCYF|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_DELAWARE DSCYF|LOCAL GOVT] standard_charge|[payer_ESSENCE HEALTHCARE|MANAGED MEDICARE] standard_charge|[payer_ESSENCE HEALTHCARE|MANAGED MEDICARE] |percent standard_charge|[payer_ESSENCE HEALTHCARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_ESSENCE HEALTHCARE|MANAGED MEDICARE] standard_charge|[payer_FL KIDS CENTRAL GOVT|LOCAL GOVT] standard_charge|[payer_FL KIDS CENTRAL GOVT|LOCAL GOVT] |percent standard_charge|[payer_FL KIDS CENTRAL GOVT|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_FL KIDS CENTRAL GOVT|LOCAL GOVT] standard_charge|[payer_FLORIDA ACCESS BEHAVIORAL|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA ACCESS BEHAVIORAL|MEDICAID: CBS OOS] |percent standard_charge|[payer_FLORIDA ACCESS BEHAVIORAL|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_FLORIDA ACCESS BEHAVIORAL|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA BEACON|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA BEACON|MEDICAID: CBS OOS] |percent standard_charge|[payer_FLORIDA BEACON|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_FLORIDA BEACON|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA BEACON|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA BEACON|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_FLORIDA BEACON|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_FLORIDA BEACON|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA MAGELLEN COMPLETE|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA MAGELLEN COMPLETE|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_FLORIDA MAGELLEN COMPLETE|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_FLORIDA MAGELLEN COMPLETE|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA MOLINA|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA MOLINA|MEDICAID: CBS OOS] |percent standard_charge|[payer_FLORIDA MOLINA|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_FLORIDA MOLINA|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA SUNSHINECENPATICO|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA SUNSHINECENPATICO|MEDICAID: CBS OOS] |percent standard_charge|[payer_FLORIDA SUNSHINECENPATICO|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_FLORIDA SUNSHINECENPATICO|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA SUNSHINECENPATICO|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA SUNSHINECENPATICO|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_FLORIDA SUNSHINECENPATICO|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_FLORIDA SUNSHINECENPATICO|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA WELLCARE|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA WELLCARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_FLORIDA WELLCARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_FLORIDA WELLCARE|MEDICAID: CBS OOS] standard_charge|[payer_FLORIDA WELLCARE|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA WELLCARE|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_FLORIDA WELLCARE|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_FLORIDA WELLCARE|MEDICAID: OUT OF STATE] standard_charge|[payer_FRINGE BENEFIT GROUP|COMMERCIAL] standard_charge|[payer_FRINGE BENEFIT GROUP|COMMERCIAL] |percent standard_charge|[payer_FRINGE BENEFIT GROUP|COMMERCIAL] |contracting_method additional_payer_notes |[payer_FRINGE BENEFIT GROUP|COMMERCIAL] standard_charge|[payer_GOLDEN RULE|HMO/PPO] standard_charge|[payer_GOLDEN RULE|HMO/PPO] |percent standard_charge|[payer_GOLDEN RULE|HMO/PPO] |contracting_method additional_payer_notes |[payer_GOLDEN RULE|HMO/PPO] standard_charge|[payer_HAWAII CAMHD|LOCAL GOVT] standard_charge|[payer_HAWAII CAMHD|LOCAL GOVT] |percent standard_charge|[payer_HAWAII CAMHD|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_HAWAII CAMHD|LOCAL GOVT] standard_charge|[payer_HAWAII HMSA MEDICAID BC|MEDICAID: OUT OF STATE] standard_charge|[payer_HAWAII HMSA MEDICAID BC|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_HAWAII HMSA MEDICAID BC|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_HAWAII HMSA MEDICAID BC|MEDICAID: OUT OF STATE] standard_charge|[payer_HEALTH CHOICE|COMMERCIAL] standard_charge|[payer_HEALTH CHOICE|COMMERCIAL] |percent standard_charge|[payer_HEALTH CHOICE|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HEALTH CHOICE|COMMERCIAL] standard_charge|[payer_HUMANA GOLD|MANAGED MEDICARE] standard_charge|[payer_HUMANA GOLD|MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA GOLD|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA GOLD|MANAGED MEDICARE] standard_charge|[payer_IDAHO IDHW|LOCAL GOVT] standard_charge|[payer_IDAHO IDHW|LOCAL GOVT] |percent standard_charge|[payer_IDAHO IDHW|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_IDAHO IDHW|LOCAL GOVT] standard_charge|[payer_IDAHO MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_IDAHO MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_IDAHO MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_IDAHO MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_IDAHO MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_IDAHO MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_IDAHO MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_IDAHO MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_ILLINOIS DCFS|LOCAL GOVT] standard_charge|[payer_ILLINOIS DCFS|LOCAL GOVT] |percent standard_charge|[payer_ILLINOIS DCFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ILLINOIS DCFS|LOCAL GOVT] standard_charge|[payer_ILLINOIS HFS|LOCAL GOVT] standard_charge|[payer_ILLINOIS HFS|LOCAL GOVT] |percent standard_charge|[payer_ILLINOIS HFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ILLINOIS HFS|LOCAL GOVT] standard_charge|[payer_IOWA DHS|LOCAL GOVT] standard_charge|[payer_IOWA DHS|LOCAL GOVT] |percent standard_charge|[payer_IOWA DHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_IOWA DHS|LOCAL GOVT] standard_charge|[payer_IOWA MCD AMERIGROUP INC|MEDICAID: CBS OOS] standard_charge|[payer_IOWA MCD AMERIGROUP INC|MEDICAID: CBS OOS] |percent standard_charge|[payer_IOWA MCD AMERIGROUP INC|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_IOWA MCD AMERIGROUP INC|MEDICAID: CBS OOS] standard_charge|[payer_IOWA MCD AMERIGROUP INC|MEDICAID: OUT OF STATE] standard_charge|[payer_IOWA MCD AMERIGROUP INC|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_IOWA MCD AMERIGROUP INC|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_IOWA MCD AMERIGROUP INC|MEDICAID: OUT OF STATE] standard_charge|[payer_IOWA MCD TOTAL CARE|MEDICAID: CBS OOS] standard_charge|[payer_IOWA MCD TOTAL CARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_IOWA MCD TOTAL CARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_IOWA MCD TOTAL CARE|MEDICAID: CBS OOS] standard_charge|[payer_IOWA MEDICAID FFS|MEDICAID: CBS OOS] standard_charge|[payer_IOWA MEDICAID FFS|MEDICAID: CBS OOS] |percent standard_charge|[payer_IOWA MEDICAID FFS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_IOWA MEDICAID FFS|MEDICAID: CBS OOS] standard_charge|[payer_IOWA MEDICAID FFS|MEDICAID: OUT OF STATE] standard_charge|[payer_IOWA MEDICAID FFS|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_IOWA MEDICAID FFS|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_IOWA MEDICAID FFS|MEDICAID: OUT OF STATE] standard_charge|[payer_KANSAS AETNA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_KANSAS AETNA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_KANSAS AETNA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_KANSAS AETNA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_KANSAS AETNA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_KANSAS AETNA MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_KANSAS AETNA MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_KANSAS AETNA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_KANSAS MERCY AETNA|MEDICAID: CBS OOS] standard_charge|[payer_KANSAS MERCY AETNA|MEDICAID: CBS OOS] |percent standard_charge|[payer_KANSAS MERCY AETNA|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_KANSAS MERCY AETNA|MEDICAID: CBS OOS] standard_charge|[payer_KANSAS SUNFLOWER MCD|MEDICAID: CBS OOS] standard_charge|[payer_KANSAS SUNFLOWER MCD|MEDICAID: CBS OOS] |percent standard_charge|[payer_KANSAS SUNFLOWER MCD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_KANSAS SUNFLOWER MCD|MEDICAID: CBS OOS] standard_charge|[payer_KANSAS SUNFLOWER MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_KANSAS SUNFLOWER MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_KANSAS SUNFLOWER MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_KANSAS SUNFLOWER MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_KANSAS UHC KANCARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_KANSAS UHC KANCARE MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_KANSAS UHC KANCARE MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_KANSAS UHC KANCARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_KENTUCKY AETNA MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_KENTUCKY AETNA MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_KENTUCKY AETNA MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_KENTUCKY AETNA MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_KENTUCKY DCBS|LOCAL GOVT] standard_charge|[payer_KENTUCKY DCBS|LOCAL GOVT] |percent standard_charge|[payer_KENTUCKY DCBS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_KENTUCKY DCBS|LOCAL GOVT] standard_charge|[payer_KENTUCKY MOLINA|MEDICAID: CBS OOS] standard_charge|[payer_KENTUCKY MOLINA|MEDICAID: CBS OOS] |percent standard_charge|[payer_KENTUCKY MOLINA|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_KENTUCKY MOLINA|MEDICAID: CBS OOS] standard_charge|[payer_KENTUCKY WELLCARE MCD|MEDICAID: CBS OOS] standard_charge|[payer_KENTUCKY WELLCARE MCD|MEDICAID: CBS OOS] |percent standard_charge|[payer_KENTUCKY WELLCARE MCD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_KENTUCKY WELLCARE MCD|MEDICAID: CBS OOS] standard_charge|[payer_KENTUCKY WELLCARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_KENTUCKY WELLCARE MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_KENTUCKY WELLCARE MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_KENTUCKY WELLCARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_LOUISANA HEALTHY BLUE|MEDICAID: CBS OOS] standard_charge|[payer_LOUISANA HEALTHY BLUE|MEDICAID: CBS OOS] |percent standard_charge|[payer_LOUISANA HEALTHY BLUE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_LOUISANA HEALTHY BLUE|MEDICAID: CBS OOS] standard_charge|[payer_LOUISANA HLTHCARE CONNECT|MEDICAID: CBS OOS] standard_charge|[payer_LOUISANA HLTHCARE CONNECT|MEDICAID: CBS OOS] |percent standard_charge|[payer_LOUISANA HLTHCARE CONNECT|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_LOUISANA HLTHCARE CONNECT|MEDICAID: CBS OOS] standard_charge|[payer_LOUISANA UHC MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_LOUISANA UHC MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_LOUISANA UHC MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_LOUISANA UHC MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_LOUISANA UHC MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_LOUISANA UHC MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_LOUISANA UHC MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_LOUISANA UHC MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_MAGELLAN HEALTH|COMMERCIAL] standard_charge|[payer_MAGELLAN HEALTH|COMMERCIAL] |percent standard_charge|[payer_MAGELLAN HEALTH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MAGELLAN HEALTH|COMMERCIAL] standard_charge|[payer_MAINE OCFS|LOCAL GOVT] standard_charge|[payer_MAINE OCFS|LOCAL GOVT] |percent standard_charge|[payer_MAINE OCFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MAINE OCFS|LOCAL GOVT] standard_charge|[payer_MAINECARE MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_MAINECARE MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_MAINECARE MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MAINECARE MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_MAINECARE MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_MAINECARE MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MAINECARE MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MAINECARE MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_MARYLAND DHS|LOCAL GOVT] standard_charge|[payer_MARYLAND DHS|LOCAL GOVT] |percent standard_charge|[payer_MARYLAND DHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MARYLAND DHS|LOCAL GOVT] standard_charge|[payer_MCC OF FL|MEDICAID: CBS OOS] standard_charge|[payer_MCC OF FL|MEDICAID: CBS OOS] |percent standard_charge|[payer_MCC OF FL|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MCC OF FL|MEDICAID: CBS OOS] standard_charge|[payer_MED PAY|HMO/PPO] standard_charge|[payer_MED PAY|HMO/PPO] |percent standard_charge|[payer_MED PAY|HMO/PPO] |contracting_method additional_payer_notes |[payer_MED PAY|HMO/PPO] standard_charge|[payer_MEDICAID PENDING|PENDING MEDICAID] standard_charge|[payer_MEDICAID PENDING|PENDING MEDICAID] |percent standard_charge|[payer_MEDICAID PENDING|PENDING MEDICAID] |contracting_method additional_payer_notes |[payer_MEDICAID PENDING|PENDING MEDICAID] standard_charge|[payer_MERCY MO HLTHY BLUE|MANAGED MEDICAID] standard_charge|[payer_MERCY MO HLTHY BLUE|MANAGED MEDICAID] |percent standard_charge|[payer_MERCY MO HLTHY BLUE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MERCY MO HLTHY BLUE|MANAGED MEDICAID] standard_charge|[payer_MERITAIN HEALTH|COMMERCIAL] standard_charge|[payer_MERITAIN HEALTH|COMMERCIAL] |percent standard_charge|[payer_MERITAIN HEALTH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MERITAIN HEALTH|COMMERCIAL] standard_charge|[payer_MH NET|HMO/PPO] standard_charge|[payer_MH NET|HMO/PPO] |percent standard_charge|[payer_MH NET|HMO/PPO] |contracting_method additional_payer_notes |[payer_MH NET|HMO/PPO] standard_charge|[payer_MH NET|MANAGED MEDICARE] standard_charge|[payer_MH NET|MANAGED MEDICARE] |percent standard_charge|[payer_MH NET|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MH NET|MANAGED MEDICARE] standard_charge|[payer_MICHIGAN DHHR|LOCAL GOVT] standard_charge|[payer_MICHIGAN DHHR|LOCAL GOVT] |percent standard_charge|[payer_MICHIGAN DHHR|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MICHIGAN DHHR|LOCAL GOVT] standard_charge|[payer_MINES & ASSOC CO|COMMERCIAL] standard_charge|[payer_MINES & ASSOC CO|COMMERCIAL] |percent standard_charge|[payer_MINES & ASSOC CO|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MINES & ASSOC CO|COMMERCIAL] standard_charge|[payer_MINNESOTA CROWWING|LOCAL GOVT] standard_charge|[payer_MINNESOTA CROWWING|LOCAL GOVT] |percent standard_charge|[payer_MINNESOTA CROWWING|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MINNESOTA CROWWING|LOCAL GOVT] standard_charge|[payer_MINNESOTA DSS ANOKA CO|LOCAL GOVT] standard_charge|[payer_MINNESOTA DSS ANOKA CO|LOCAL GOVT] |percent standard_charge|[payer_MINNESOTA DSS ANOKA CO|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MINNESOTA DSS ANOKA CO|LOCAL GOVT] standard_charge|[payer_MINNESOTA LOCAL GOVT|LOCAL GOVT] standard_charge|[payer_MINNESOTA LOCAL GOVT|LOCAL GOVT] |percent standard_charge|[payer_MINNESOTA LOCAL GOVT|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MINNESOTA LOCAL GOVT|LOCAL GOVT] standard_charge|[payer_MINNESOTA OLMSTED CTY|LOCAL GOVT] standard_charge|[payer_MINNESOTA OLMSTED CTY|LOCAL GOVT] |percent standard_charge|[payer_MINNESOTA OLMSTED CTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MINNESOTA OLMSTED CTY|LOCAL GOVT] standard_charge|[payer_MINNESOTA OTTER TAIL CTY|LOCAL GOVT] standard_charge|[payer_MINNESOTA OTTER TAIL CTY|LOCAL GOVT] |percent standard_charge|[payer_MINNESOTA OTTER TAIL CTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MINNESOTA OTTER TAIL CTY|LOCAL GOVT] standard_charge|[payer_MISSOURI ADULT MEDICAID|SELF PAY CHARITY] standard_charge|[payer_MISSOURI ADULT MEDICAID|SELF PAY CHARITY] |percent standard_charge|[payer_MISSOURI ADULT MEDICAID|SELF PAY CHARITY] |contracting_method additional_payer_notes |[payer_MISSOURI ADULT MEDICAID|SELF PAY CHARITY] standard_charge|[payer_MISSOURI ALLIANCE|LOCAL GOVT] standard_charge|[payer_MISSOURI ALLIANCE|LOCAL GOVT] |percent standard_charge|[payer_MISSOURI ALLIANCE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MISSOURI ALLIANCE|LOCAL GOVT] standard_charge|[payer_MISSOURI CENPATICO MCD|MANAGED MEDICAID] standard_charge|[payer_MISSOURI CENPATICO MCD|MANAGED MEDICAID] |percent standard_charge|[payer_MISSOURI CENPATICO MCD|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MISSOURI CENPATICO MCD|MANAGED MEDICAID] standard_charge|[payer_MISSOURI CPP|LOCAL GOVT] standard_charge|[payer_MISSOURI CPP|LOCAL GOVT] |percent standard_charge|[payer_MISSOURI CPP|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MISSOURI CPP|LOCAL GOVT] standard_charge|[payer_MISSOURI DSS|LOCAL GOVT] standard_charge|[payer_MISSOURI DSS|LOCAL GOVT] |percent standard_charge|[payer_MISSOURI DSS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MISSOURI DSS|LOCAL GOVT] standard_charge|[payer_MISSOURI DYS|LOCAL GOVT] standard_charge|[payer_MISSOURI DYS|LOCAL GOVT] |percent standard_charge|[payer_MISSOURI DYS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MISSOURI DYS|LOCAL GOVT] standard_charge|[payer_MISSOURI EVERY CHILDS HOP|LOCAL GOVT] standard_charge|[payer_MISSOURI EVERY CHILDS HOP|LOCAL GOVT] |percent standard_charge|[payer_MISSOURI EVERY CHILDS HOP|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MISSOURI EVERY CHILDS HOP|LOCAL GOVT] standard_charge|[payer_MISSOURI GREAT CIRCLE|LOCAL GOVT] standard_charge|[payer_MISSOURI GREAT CIRCLE|LOCAL GOVT] |percent standard_charge|[payer_MISSOURI GREAT CIRCLE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MISSOURI GREAT CIRCLE|LOCAL GOVT] standard_charge|[payer_MISSOURI HEALTHY BLUE MCD|MANAGED MEDICAID] standard_charge|[payer_MISSOURI HEALTHY BLUE MCD|MANAGED MEDICAID] |percent standard_charge|[payer_MISSOURI HEALTHY BLUE MCD|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MISSOURI HEALTHY BLUE MCD|MANAGED MEDICAID] standard_charge|[payer_MISSOURI MEDICAID|MEDICAID ] standard_charge|[payer_MISSOURI MEDICAID|MEDICAID ] |percent standard_charge|[payer_MISSOURI MEDICAID|MEDICAID ] |contracting_method additional_payer_notes |[payer_MISSOURI MEDICAID|MEDICAID ] standard_charge|[payer_MISSOURI SUBACUTE|LOCAL GOVT] standard_charge|[payer_MISSOURI SUBACUTE|LOCAL GOVT] |percent standard_charge|[payer_MISSOURI SUBACUTE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MISSOURI SUBACUTE|LOCAL GOVT] standard_charge|[payer_MISSOURI UHC MEDICAID|MANAGED MEDICAID] standard_charge|[payer_MISSOURI UHC MEDICAID|MANAGED MEDICAID] |percent standard_charge|[payer_MISSOURI UHC MEDICAID|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MISSOURI UHC MEDICAID|MANAGED MEDICAID] standard_charge|[payer_MO ALLIANCE SUBACUTE|LOCAL GOVT] standard_charge|[payer_MO ALLIANCE SUBACUTE|LOCAL GOVT] |percent standard_charge|[payer_MO ALLIANCE SUBACUTE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MO ALLIANCE SUBACUTE|LOCAL GOVT] standard_charge|[payer_MO SHOW ME HEALTHY KIDS|LOCAL GOVT] standard_charge|[payer_MO SHOW ME HEALTHY KIDS|LOCAL GOVT] |percent standard_charge|[payer_MO SHOW ME HEALTHY KIDS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MO SHOW ME HEALTHY KIDS|LOCAL GOVT] standard_charge|[payer_MO SHOW ME HEALTHY KIDS|MANAGED MEDICAID] standard_charge|[payer_MO SHOW ME HEALTHY KIDS|MANAGED MEDICAID] |percent standard_charge|[payer_MO SHOW ME HEALTHY KIDS|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MO SHOW ME HEALTHY KIDS|MANAGED MEDICAID] standard_charge|[payer_MONTANA DPHHS|LOCAL GOVT] standard_charge|[payer_MONTANA DPHHS|LOCAL GOVT] |percent standard_charge|[payer_MONTANA DPHHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MONTANA DPHHS|LOCAL GOVT] standard_charge|[payer_MONTANA MCD TPL ENTER INS|MEDICAID: CBS OOS] standard_charge|[payer_MONTANA MCD TPL ENTER INS|MEDICAID: CBS OOS] |percent standard_charge|[payer_MONTANA MCD TPL ENTER INS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MONTANA MCD TPL ENTER INS|MEDICAID: CBS OOS] standard_charge|[payer_MONTANA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_MONTANA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_MONTANA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MONTANA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_MONTANA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_MONTANA MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MONTANA MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MONTANA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_MUTUAL OF OMAHA|COMMERCIAL] standard_charge|[payer_MUTUAL OF OMAHA|COMMERCIAL] |percent standard_charge|[payer_MUTUAL OF OMAHA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MUTUAL OF OMAHA|COMMERCIAL] standard_charge|[payer_NEBRASKA DHHS|LOCAL GOVT] standard_charge|[payer_NEBRASKA DHHS|LOCAL GOVT] |percent standard_charge|[payer_NEBRASKA DHHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_NEBRASKA DHHS|LOCAL GOVT] standard_charge|[payer_NEBRASKA DJJ|LOCAL GOVT] standard_charge|[payer_NEBRASKA DJJ|LOCAL GOVT] |percent standard_charge|[payer_NEBRASKA DJJ|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_NEBRASKA DJJ|LOCAL GOVT] standard_charge|[payer_NEBRASKA HEALTHY BLUE MCD|MEDICAID: CBS OOS] standard_charge|[payer_NEBRASKA HEALTHY BLUE MCD|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEBRASKA HEALTHY BLUE MCD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEBRASKA HEALTHY BLUE MCD|MEDICAID: CBS OOS] standard_charge|[payer_NEBRASKA HEALTHY BLUE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_NEBRASKA HEALTHY BLUE MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEBRASKA HEALTHY BLUE MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEBRASKA HEALTHY BLUE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_NEBRASKA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NEBRASKA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEBRASKA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEBRASKA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NEBRASKA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_NEBRASKA MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEBRASKA MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEBRASKA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_NEBRASKA TOTALCARE MCD|MEDICAID: CBS OOS] standard_charge|[payer_NEBRASKA TOTALCARE MCD|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEBRASKA TOTALCARE MCD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEBRASKA TOTALCARE MCD|MEDICAID: CBS OOS] standard_charge|[payer_NEBRASKA TOTALCARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_NEBRASKA TOTALCARE MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEBRASKA TOTALCARE MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEBRASKA TOTALCARE MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_NEBRASKA TPL|LOCAL GOVT] standard_charge|[payer_NEBRASKA TPL|LOCAL GOVT] |percent standard_charge|[payer_NEBRASKA TPL|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_NEBRASKA TPL|LOCAL GOVT] standard_charge|[payer_NEBRASKA UHC|MEDICAID: CBS OOS] standard_charge|[payer_NEBRASKA UHC|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEBRASKA UHC|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEBRASKA UHC|MEDICAID: CBS OOS] standard_charge|[payer_NEBRASKA UHC|MEDICAID: OUT OF STATE] standard_charge|[payer_NEBRASKA UHC|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEBRASKA UHC|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEBRASKA UHC|MEDICAID: OUT OF STATE] standard_charge|[payer_NEVADA DHHS|LOCAL GOVT] standard_charge|[payer_NEVADA DHHS|LOCAL GOVT] |percent standard_charge|[payer_NEVADA DHHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_NEVADA DHHS|LOCAL GOVT] standard_charge|[payer_NEVADA HEALTH PLAN MCO|MEDICAID: CBS OOS] standard_charge|[payer_NEVADA HEALTH PLAN MCO|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEVADA HEALTH PLAN MCO|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEVADA HEALTH PLAN MCO|MEDICAID: CBS OOS] standard_charge|[payer_NEVADA HEALTH PLAN MCO|MEDICAID: OUT OF STATE] standard_charge|[payer_NEVADA HEALTH PLAN MCO|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEVADA HEALTH PLAN MCO|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEVADA HEALTH PLAN MCO|MEDICAID: OUT OF STATE] standard_charge|[payer_NEVADA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NEVADA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEVADA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEVADA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NEVADA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_NEVADA MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEVADA MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEVADA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_NEVADA SILVERSUMMIT|MEDICAID: CBS OOS] standard_charge|[payer_NEVADA SILVERSUMMIT|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEVADA SILVERSUMMIT|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEVADA SILVERSUMMIT|MEDICAID: CBS OOS] standard_charge|[payer_NEVADA SILVERSUMMIT|MEDICAID: OUT OF STATE] standard_charge|[payer_NEVADA SILVERSUMMIT|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEVADA SILVERSUMMIT|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEVADA SILVERSUMMIT|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW HAMPSHIRE BEACON MCD|MEDICAID: CBS OOS] standard_charge|[payer_NEW HAMPSHIRE BEACON MCD|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEW HAMPSHIRE BEACON MCD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEW HAMPSHIRE BEACON MCD|MEDICAID: CBS OOS] standard_charge|[payer_NEW HAMPSHIRE BEACON MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW HAMPSHIRE BEACON MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEW HAMPSHIRE BEACON MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEW HAMPSHIRE BEACON MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW HAMPSHIRE DHHS DCYF|LOCAL GOVT] standard_charge|[payer_NEW HAMPSHIRE DHHS DCYF|LOCAL GOVT] |percent standard_charge|[payer_NEW HAMPSHIRE DHHS DCYF|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_NEW HAMPSHIRE DHHS DCYF|LOCAL GOVT] standard_charge|[payer_NEW HAMPSHIRE MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NEW HAMPSHIRE MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEW HAMPSHIRE MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEW HAMPSHIRE MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NEW HAMPSHIRE MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW HAMPSHIRE MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEW HAMPSHIRE MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEW HAMPSHIRE MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW MEX MCD BCBS|MEDICAID: CBS OOS] standard_charge|[payer_NEW MEX MCD BCBS|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEW MEX MCD BCBS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEW MEX MCD BCBS|MEDICAID: CBS OOS] standard_charge|[payer_NEW MEX MCD BCBS|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW MEX MCD BCBS|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEW MEX MCD BCBS|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEW MEX MCD BCBS|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW MEX MCD PRES MAGELLAN|MEDICAID: CBS OOS] standard_charge|[payer_NEW MEX MCD PRES MAGELLAN|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEW MEX MCD PRES MAGELLAN|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEW MEX MCD PRES MAGELLAN|MEDICAID: CBS OOS] standard_charge|[payer_NEW MEX MCD PRES MAGELLAN|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW MEX MCD PRES MAGELLAN|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEW MEX MCD PRES MAGELLAN|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEW MEX MCD PRES MAGELLAN|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW MEX MCD TPL ENTER INS|MEDICAID: CBS OOS] standard_charge|[payer_NEW MEX MCD TPL ENTER INS|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEW MEX MCD TPL ENTER INS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEW MEX MCD TPL ENTER INS|MEDICAID: CBS OOS] standard_charge|[payer_NEW MEX MCD WESTERN SKY|MEDICAID: CBS OOS] standard_charge|[payer_NEW MEX MCD WESTERN SKY|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEW MEX MCD WESTERN SKY|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEW MEX MCD WESTERN SKY|MEDICAID: CBS OOS] standard_charge|[payer_NEW MEX MCD WESTERN SKY|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW MEX MCD WESTERN SKY|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEW MEX MCD WESTERN SKY|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEW MEX MCD WESTERN SKY|MEDICAID: OUT OF STATE] standard_charge|[payer_NORTH CAROLINA EASTPOINT|MEDICAID: CBS OOS] standard_charge|[payer_NORTH CAROLINA EASTPOINT|MEDICAID: CBS OOS] |percent standard_charge|[payer_NORTH CAROLINA EASTPOINT|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NORTH CAROLINA EASTPOINT|MEDICAID: CBS OOS] standard_charge|[payer_OHIO AETNA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_OHIO AETNA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_OHIO AETNA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OHIO AETNA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_OHIO BUTLER COUNTY|LOCAL GOVT] standard_charge|[payer_OHIO BUTLER COUNTY|LOCAL GOVT] |percent standard_charge|[payer_OHIO BUTLER COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OHIO BUTLER COUNTY|LOCAL GOVT] standard_charge|[payer_OHIO COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_OHIO COUNTY|MEDICAID: CBS OOS] |percent standard_charge|[payer_OHIO COUNTY|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OHIO COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_OHIO FRANKLIN COUNTY|LOCAL GOVT] standard_charge|[payer_OHIO FRANKLIN COUNTY|LOCAL GOVT] |percent standard_charge|[payer_OHIO FRANKLIN COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OHIO FRANKLIN COUNTY|LOCAL GOVT] standard_charge|[payer_OHIO HAMILTON DJFS|LOCAL GOVT] standard_charge|[payer_OHIO HAMILTON DJFS|LOCAL GOVT] |percent standard_charge|[payer_OHIO HAMILTON DJFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OHIO HAMILTON DJFS|LOCAL GOVT] standard_charge|[payer_OHIO MIAMI COUNTY|LOCAL GOVT] standard_charge|[payer_OHIO MIAMI COUNTY|LOCAL GOVT] |percent standard_charge|[payer_OHIO MIAMI COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OHIO MIAMI COUNTY|LOCAL GOVT] standard_charge|[payer_OHIO MONTGOMERY CTY|LOCAL GOVT] standard_charge|[payer_OHIO MONTGOMERY CTY|LOCAL GOVT] |percent standard_charge|[payer_OHIO MONTGOMERY CTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OHIO MONTGOMERY CTY|LOCAL GOVT] standard_charge|[payer_OKLAHOMA BRYAN CTY|LOCAL GOVT] standard_charge|[payer_OKLAHOMA BRYAN CTY|LOCAL GOVT] |percent standard_charge|[payer_OKLAHOMA BRYAN CTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OKLAHOMA BRYAN CTY|LOCAL GOVT] standard_charge|[payer_OKLAHOMA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_OKLAHOMA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_OKLAHOMA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OKLAHOMA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_OKLAHOMA MEDICAID OHCA|MEDICAID: OUT OF STATE] standard_charge|[payer_OKLAHOMA MEDICAID OHCA|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_OKLAHOMA MEDICAID OHCA|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_OKLAHOMA MEDICAID OHCA|MEDICAID: OUT OF STATE] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|MANAGED MEDICARE] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|MANAGED MEDICARE] |percent standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_OPTUM BEHAVIORAL HEALTH|MANAGED MEDICARE] standard_charge|[payer_OUT OF STATE|MEDICAID: CBS OOS] standard_charge|[payer_OUT OF STATE|MEDICAID: CBS OOS] |percent standard_charge|[payer_OUT OF STATE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OUT OF STATE|MEDICAID: CBS OOS] standard_charge|[payer_PENNSYLVANIA MCD CCBH|MEDICAID: CBS OOS] standard_charge|[payer_PENNSYLVANIA MCD CCBH|MEDICAID: CBS OOS] |percent standard_charge|[payer_PENNSYLVANIA MCD CCBH|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_PENNSYLVANIA MCD CCBH|MEDICAID: CBS OOS] standard_charge|[payer_PENNSYLVANIA YORK COUNTY|LOCAL GOVT] standard_charge|[payer_PENNSYLVANIA YORK COUNTY|LOCAL GOVT] |percent standard_charge|[payer_PENNSYLVANIA YORK COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_PENNSYLVANIA YORK COUNTY|LOCAL GOVT] standard_charge|[payer_PRESBYTERIAN MAGELLAN|HMO/PPO] standard_charge|[payer_PRESBYTERIAN MAGELLAN|HMO/PPO] |percent standard_charge|[payer_PRESBYTERIAN MAGELLAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_PRESBYTERIAN MAGELLAN|HMO/PPO] standard_charge|[payer_RHODE ISLAND DCYF|LOCAL GOVT] standard_charge|[payer_RHODE ISLAND DCYF|LOCAL GOVT] |percent standard_charge|[payer_RHODE ISLAND DCYF|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_RHODE ISLAND DCYF|LOCAL GOVT] standard_charge|[payer_SOUTH CAROLINA BLUECHOICE|MEDICAID: CBS OOS] standard_charge|[payer_SOUTH CAROLINA BLUECHOICE|MEDICAID: CBS OOS] |percent standard_charge|[payer_SOUTH CAROLINA BLUECHOICE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_SOUTH CAROLINA BLUECHOICE|MEDICAID: CBS OOS] standard_charge|[payer_TENN MCD AMERIGROUP|MEDICAID: CBS OOS] standard_charge|[payer_TENN MCD AMERIGROUP|MEDICAID: CBS OOS] |percent standard_charge|[payer_TENN MCD AMERIGROUP|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_TENN MCD AMERIGROUP|MEDICAID: CBS OOS] standard_charge|[payer_TENN MCD BLUECARE|MEDICAID: CBS OOS] standard_charge|[payer_TENN MCD BLUECARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_TENN MCD BLUECARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_TENN MCD BLUECARE|MEDICAID: CBS OOS] standard_charge|[payer_TENNESSEE DCS|LOCAL GOVT] standard_charge|[payer_TENNESSEE DCS|LOCAL GOVT] |percent standard_charge|[payer_TENNESSEE DCS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TENNESSEE DCS|LOCAL GOVT] standard_charge|[payer_TEXAS 2INGAGE|LOCAL GOVT] standard_charge|[payer_TEXAS 2INGAGE|LOCAL GOVT] |percent standard_charge|[payer_TEXAS 2INGAGE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TEXAS 2INGAGE|LOCAL GOVT] standard_charge|[payer_TEXAS DFPS|LOCAL GOVT] standard_charge|[payer_TEXAS DFPS|LOCAL GOVT] |percent standard_charge|[payer_TEXAS DFPS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TEXAS DFPS|LOCAL GOVT] standard_charge|[payer_THE LOOMIS COMPANY|COMMERCIAL] standard_charge|[payer_THE LOOMIS COMPANY|COMMERCIAL] |percent standard_charge|[payer_THE LOOMIS COMPANY|COMMERCIAL] |contracting_method additional_payer_notes |[payer_THE LOOMIS COMPANY|COMMERCIAL] standard_charge|[payer_TRICARE EAST|TRICARE] standard_charge|[payer_TRICARE EAST|TRICARE] |percent standard_charge|[payer_TRICARE EAST|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE EAST|TRICARE] standard_charge|[payer_TRICARE OVERSEAS|TRICARE] standard_charge|[payer_TRICARE OVERSEAS|TRICARE] |percent standard_charge|[payer_TRICARE OVERSEAS|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE OVERSEAS|TRICARE] standard_charge|[payer_TRICARE WEST HNFS|TRICARE] standard_charge|[payer_TRICARE WEST HNFS|TRICARE] |percent standard_charge|[payer_TRICARE WEST HNFS|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE WEST HNFS|TRICARE] standard_charge|[payer_TX BELONG SJRC|LOCAL GOVT] standard_charge|[payer_TX BELONG SJRC|LOCAL GOVT] |percent standard_charge|[payer_TX BELONG SJRC|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TX BELONG SJRC|LOCAL GOVT] standard_charge|[payer_UBH|COMMERCIAL] standard_charge|[payer_UBH|COMMERCIAL] |percent standard_charge|[payer_UBH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_UBH|COMMERCIAL] standard_charge|[payer_UBH|HMO/PPO] standard_charge|[payer_UBH|HMO/PPO] |percent standard_charge|[payer_UBH|HMO/PPO] |contracting_method additional_payer_notes |[payer_UBH|HMO/PPO] standard_charge|[payer_UBH MEDICARE|MANAGED MEDICARE] standard_charge|[payer_UBH MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_UBH MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UBH MEDICARE|MANAGED MEDICARE] standard_charge|[payer_UBH MEDICARE DUALCOMPLETE|MANAGED MEDICARE] standard_charge|[payer_UBH MEDICARE DUALCOMPLETE|MANAGED MEDICARE] |percent standard_charge|[payer_UBH MEDICARE DUALCOMPLETE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UBH MEDICARE DUALCOMPLETE|MANAGED MEDICARE] standard_charge|[payer_UCHEALTH PLAN ADMIN LLC|COMMERCIAL] standard_charge|[payer_UCHEALTH PLAN ADMIN LLC|COMMERCIAL] |percent standard_charge|[payer_UCHEALTH PLAN ADMIN LLC|COMMERCIAL] |contracting_method additional_payer_notes |[payer_UCHEALTH PLAN ADMIN LLC|COMMERCIAL] standard_charge|[payer_UHC ALL SAVERS|HMO/PPO] standard_charge|[payer_UHC ALL SAVERS|HMO/PPO] |percent standard_charge|[payer_UHC ALL SAVERS|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC ALL SAVERS|HMO/PPO] standard_charge|[payer_UHC GLOBAL|COMMERCIAL] standard_charge|[payer_UHC GLOBAL|COMMERCIAL] |percent standard_charge|[payer_UHC GLOBAL|COMMERCIAL] |contracting_method additional_payer_notes |[payer_UHC GLOBAL|COMMERCIAL] standard_charge|[payer_UMR|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO] |percent standard_charge|[payer_UMR|HMO/PPO] |contracting_method additional_payer_notes |[payer_UMR|HMO/PPO] standard_charge|[payer_UMR QUAPAW TRIBAL|HMO/PPO] standard_charge|[payer_UMR QUAPAW TRIBAL|HMO/PPO] |percent standard_charge|[payer_UMR QUAPAW TRIBAL|HMO/PPO] |contracting_method additional_payer_notes |[payer_UMR QUAPAW TRIBAL|HMO/PPO] standard_charge|[payer_VERMONT DCFS|LOCAL GOVT] standard_charge|[payer_VERMONT DCFS|LOCAL GOVT] |percent standard_charge|[payer_VERMONT DCFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_VERMONT DCFS|LOCAL GOVT] standard_charge|[payer_VIRGINIA BEACH DHS|LOCAL GOVT] standard_charge|[payer_VIRGINIA BEACH DHS|LOCAL GOVT] |percent standard_charge|[payer_VIRGINIA BEACH DHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_VIRGINIA BEACH DHS|LOCAL GOVT] standard_charge|[payer_VIRGINIA CHESAPEAKE CTY|LOCAL GOVT] standard_charge|[payer_VIRGINIA CHESAPEAKE CTY|LOCAL GOVT] |percent standard_charge|[payer_VIRGINIA CHESAPEAKE CTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_VIRGINIA CHESAPEAKE CTY|LOCAL GOVT] standard_charge|[payer_VIRGINIA DSS LEE CITY|LOCAL GOVT] standard_charge|[payer_VIRGINIA DSS LEE CITY|LOCAL GOVT] |percent standard_charge|[payer_VIRGINIA DSS LEE CITY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_VIRGINIA DSS LEE CITY|LOCAL GOVT] standard_charge|[payer_VIRGINIA MCD AETNA BETTER|MEDICAID: CBS OOS] standard_charge|[payer_VIRGINIA MCD AETNA BETTER|MEDICAID: CBS OOS] |percent standard_charge|[payer_VIRGINIA MCD AETNA BETTER|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_VIRGINIA MCD AETNA BETTER|MEDICAID: CBS OOS] standard_charge|[payer_VIRGINIA OPTIMA MGD|MEDICAID: CBS OOS] standard_charge|[payer_VIRGINIA OPTIMA MGD|MEDICAID: CBS OOS] |percent standard_charge|[payer_VIRGINIA OPTIMA MGD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_VIRGINIA OPTIMA MGD|MEDICAID: CBS OOS] standard_charge|[payer_VIRGINIA RUSSELL CTY|LOCAL GOVT] standard_charge|[payer_VIRGINIA RUSSELL CTY|LOCAL GOVT] |percent standard_charge|[payer_VIRGINIA RUSSELL CTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_VIRGINIA RUSSELL CTY|LOCAL GOVT] standard_charge|[payer_WASHINGTON DC CFSA|LOCAL GOVT] standard_charge|[payer_WASHINGTON DC CFSA|LOCAL GOVT] |percent standard_charge|[payer_WASHINGTON DC CFSA|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WASHINGTON DC CFSA|LOCAL GOVT] standard_charge|[payer_WASHINGTON DC HSCSN|MEDICAID: CBS OOS] standard_charge|[payer_WASHINGTON DC HSCSN|MEDICAID: CBS OOS] |percent standard_charge|[payer_WASHINGTON DC HSCSN|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_WASHINGTON DC HSCSN|MEDICAID: CBS OOS] standard_charge|[payer_WEST VA SUBACUTE|LOCAL GOVT] standard_charge|[payer_WEST VA SUBACUTE|LOCAL GOVT] |percent standard_charge|[payer_WEST VA SUBACUTE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WEST VA SUBACUTE|LOCAL GOVT] standard_charge|[payer_WEST VIRGINIA AETNA|MEDICAID: CBS OOS] standard_charge|[payer_WEST VIRGINIA AETNA|MEDICAID: CBS OOS] |percent standard_charge|[payer_WEST VIRGINIA AETNA|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_WEST VIRGINIA AETNA|MEDICAID: CBS OOS] standard_charge|[payer_WEST VIRGINIA DHHR|LOCAL GOVT] standard_charge|[payer_WEST VIRGINIA DHHR|LOCAL GOVT] |percent standard_charge|[payer_WEST VIRGINIA DHHR|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WEST VIRGINIA DHHR|LOCAL GOVT] standard_charge|[payer_WEST VIRGINIA HEALTH PLAN|MEDICAID: CBS OOS] standard_charge|[payer_WEST VIRGINIA HEALTH PLAN|MEDICAID: CBS OOS] |percent standard_charge|[payer_WEST VIRGINIA HEALTH PLAN|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_WEST VIRGINIA HEALTH PLAN|MEDICAID: CBS OOS] standard_charge|[payer_WEST VIRGINIA UNICARE|MEDICAID: CBS OOS] standard_charge|[payer_WEST VIRGINIA UNICARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_WEST VIRGINIA UNICARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_WEST VIRGINIA UNICARE|MEDICAID: CBS OOS] standard_charge|[payer_WISCONSIN DHS EAU CLAIRE|LOCAL GOVT] standard_charge|[payer_WISCONSIN DHS EAU CLAIRE|LOCAL GOVT] |percent standard_charge|[payer_WISCONSIN DHS EAU CLAIRE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WISCONSIN DHS EAU CLAIRE|LOCAL GOVT] standard_charge|[payer_WISCONSIN PORTAGE CTY DHS|LOCAL GOVT] standard_charge|[payer_WISCONSIN PORTAGE CTY DHS|LOCAL GOVT] |percent standard_charge|[payer_WISCONSIN PORTAGE CTY DHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WISCONSIN PORTAGE CTY DHS|LOCAL GOVT] standard_charge|[payer_WYOMING DEPT OF HEALTH|LOCAL GOVT] standard_charge|[payer_WYOMING DEPT OF HEALTH|LOCAL GOVT] |percent standard_charge|[payer_WYOMING DEPT OF HEALTH|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WYOMING DEPT OF HEALTH|LOCAL GOVT] standard_charge|[payer_WYOMING MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_WYOMING MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_WYOMING MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_WYOMING MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_WYOMING MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_WYOMING MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_WYOMING MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_WYOMING MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_WYOMING NADFS|LOCAL GOVT] standard_charge|[payer_WYOMING NADFS|LOCAL GOVT] |percent standard_charge|[payer_WYOMING NADFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WYOMING NADFS|LOCAL GOVT] standard_charge|[payer_WYOMING SUBACUTE|LOCAL GOVT] standard_charge|[payer_WYOMING SUBACUTE|LOCAL GOVT] |percent standard_charge|[payer_WYOMING SUBACUTE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WYOMING SUBACUTE|LOCAL GOVT] ROOM AND CARE ADOL 124 RC facility inpatient 2000 750 350 2000 750 per diem 750 per diem 2000 per diem 900 per diem 900 per diem 900 per diem 925 per diem 880 per diem 880 per diem 816.39 per diem 816.39 per diem 816.39 per diem 816.39 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 350 per diem 647 per diem 647 per diem 647 per diem 647 per diem 647 per diem 750 per diem 2000 per diem 1015 per diem 852 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 1950 per diem 2000 per diem 750 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 699 per diem 2000 per diem 2000 per diem 2000 per diem 1006.6 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 699 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 725 per diem 820.32 per diem 820.32 per diem 2000 per diem 738 per diem 738 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 750 per diem 2000 per diem 820.32 per diem 2000 per diem 820.32 per diem 2000 per diem 820.32 per diem 820.32 per diem 820.32 per diem 820.32 per diem 950 per diem 820.32 per diem 950 per diem 820.32 per diem 820.32 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 574 per diem 574 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 850 per diem 850 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 596.91 per diem 785 per diem 2000 per diem 2000 per diem 2000 per diem 850 per diem 1025.4 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 1248.06 per diem 1342 per diem 2000 per diem 2000 per diem 794 per diem 794 per diem 785 per diem 2000 per diem 699 per diem 750 per diem 794 per diem 699 per diem 1200 per diem 900 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 900 per diem 2000 per diem 2000 per diem 850 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 950 per diem ROOM AND CARE CHILD 124 RC facility inpatient 2000 750 350 2000 750 per diem 750 per diem 2000 per diem 900 per diem 900 per diem 900 per diem 925 per diem 880 per diem 880 per diem 816.39 per diem 816.39 per diem 816.39 per diem 816.39 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 350 per diem 647 per diem 647 per diem 647 per diem 647 per diem 647 per diem 750 per diem 2000 per diem 1015 per diem 852 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 1950 per diem 2000 per diem 750 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 699 per diem 2000 per diem 2000 per diem 2000 per diem 1006.6 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 699 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 725 per diem 820.32 per diem 820.32 per diem 1950 per diem 738 per diem 738 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 750 per diem 2000 per diem 820.32 per diem 2000 per diem 820.32 per diem 2000 per diem 820.32 per diem 820.32 per diem 820.32 per diem 820.32 per diem 950 per diem 820.32 per diem 950 per diem 820.32 per diem 820.32 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 574 per diem 574 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 850 per diem 850 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 596.91 per diem 785 per diem 2000 per diem 2000 per diem 2000 per diem 850 per diem 1025.4 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 1248.06 per diem 1342 per diem 2000 per diem 2000 per diem 794 per diem 794 per diem 785 per diem 2000 per diem 699 per diem 750 per diem 794 per diem 699 per diem 1200 per diem 900 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 900 per diem 2000 per diem 2000 per diem 850 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 950 per diem ROOM AND CARE GERI 124 RC facility inpatient 2000 750 350 2000 750 per diem 750 per diem 2000 per diem 900 per diem 900 per diem 900 per diem 925 per diem 880 per diem 880 per diem 816.39 per diem 816.39 per diem 816.39 per diem 816.39 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 350 per diem 647 per diem 647 per diem 647 per diem 647 per diem 647 per diem 750 per diem 2000 per diem 1015 per diem 852 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 1950 per diem 2000 per diem 750 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 699 per diem 2000 per diem 2000 per diem 2000 per diem 1006.6 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 699 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 725 per diem 820.32 per diem 820.32 per diem 1950 per diem 738 per diem 738 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 750 per diem 2000 per diem 820.32 per diem 2000 per diem 820.32 per diem 2000 per diem 820.32 per diem 820.32 per diem 820.32 per diem 820.32 per diem 950 per diem 820.32 per diem 950 per diem 820.32 per diem 820.32 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 574 per diem 574 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 850 per diem 850 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 596.91 per diem 785 per diem 2000 per diem 2000 per diem 2000 per diem 850 per diem 1025.4 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 1248.06 per diem 1342 per diem 2000 per diem 2000 per diem 794 per diem 794 per diem 785 per diem 2000 per diem 699 per diem 750 per diem 794 per diem 699 per diem 1200 per diem 900 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 900 per diem 2000 per diem 2000 per diem 850 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 2000 per diem 950 per diem ROOM AND CARE RTC 129 RC facility inpatient 1450 450 311.22 1950 450 per diem 1450 per diem 475 per diem 475 per diem 475 per diem 525 per diem 495 per diem 495 per diem 500 per diem 500 per diem 550 per diem 500 per diem 500 per diem 1450 per diem 550 per diem 550 per diem 1450 per diem 1450 per diem 350 per diem 350 per diem 350 per diem 350 per diem 350 per diem 500 per diem 1450 per diem 508 per diem 568 per diem 1450 per diem 765 per diem 765 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 708.5 per diem 765 per diem 1450 per diem 1450 per diem 1400 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 438.9 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 530 per diem 1450 per diem 1450 per diem 500 per diem 1400 per diem 550 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 500 per diem 1400 per diem 500 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 500 per diem 1400 per diem 450 per diem 478.04 per diem 725 per diem 1450 per diem 1450 per diem 1950 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 475 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1400 per diem 452.04 per diem 447.56 per diem 452.04 per diem 1450 per diem 484 per diem 549.86 per diem 549.86 per diem 1450 per diem 1450 per diem 549.86 per diem 549.86 per diem 1400 per diem 549.86 per diem 549.86 per diem 1450 per diem 1450 per diem 1450 per diem 515 per diem 515 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 450 per diem 450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1400 per diem 500 per diem 1450 per diem 1450 per diem 592.76 per diem 489.25 per diem 500 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 450 per diem 450 per diem 650.4 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 561.45 per diem 528.22 per diem 579.18 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 515 per diem 765 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 721 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 475.4 per diem 311.22 per diem 311.22 per diem 1450 per diem 1450 per diem THERAPUTIC LOA 183 RC facility inpatient 1450 0 350 1450 1450 per diem 475 per diem 475 per diem 475 per diem 525 per diem 500 per diem 500 per diem 500 per diem 500 per diem 1450 per diem 550 per diem 550 per diem 1450 per diem 1450 per diem 350 per diem 350 per diem 350 per diem 350 per diem 350 per diem 1450 per diem 765 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 708.5 per diem 765 per diem 1450 per diem 1450 per diem 1400 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 438.9 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 530 per diem 1450 per diem 1450 per diem 500 per diem 1400 per diem 550 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 500 per diem 1400 per diem 500 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 1400 per diem 500 per diem 1400 per diem 450 per diem 478.04 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 475 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1400 per diem 452.04 per diem 447.56 per diem 452.04 per diem 1450 per diem 484 per diem 549.86 per diem 549.86 per diem 1450 per diem 1450 per diem 549.86 per diem 549.86 per diem 1400 per diem 549.86 per diem 549.86 per diem 1450 per diem 1450 per diem 1450 per diem 515 per diem 515 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 450 per diem 450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 500 per diem 1450 per diem 1450 per diem 592.76 per diem 489.25 per diem 500 per diem 1450 per diem 1450 per diem 450 per diem 650.4 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 561.45 per diem 528.22 per diem 579.18 per diem 1450 per diem 1450 per diem 515 per diem 765 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 721 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 1450 per diem 475.4 per diem 1450 per diem 1450 per diem INTENSIVE OUTPATIENT PROGRAM ADOL PGM 905 RC facility outpatient 500 0 150 450 150 per diem 190 per diem 200 per diem 450 per diem 400 per diem 150 per diem 158 per diem 150 per diem 197.58 per diem 197.58 per diem Psych Eval with Meds 90792 RC facility inpatient/physician 250 0 99.9 185 99.9 fee schedule 139.87 fee schedule 185 fee schedule 185 fee schedule 185 fee schedule 185 fee schedule 185 fee schedule "Subsequent Hospital Care, low complexity - 15 min" 99231 RC facility inpatient/physician 120 0 46.71 46.71 46.71 fee schedule 46.71 fee schedule "Subsequent Hospital Care, moderate complexity - 25 min" 99232 RC facility inpatient/physician 140 0 58.46 100.8 83.2 fee schedule 83.2 fee schedule 64.43 fee schedule 100.8 fee schedule 63.14 fee schedule 58.46 fee schedule 90.18 fee schedule 90.18 fee schedule 90.18 fee schedule 76.2 fee schedule Initial Eval 50 min 99222 RC facility inpatient/physician 145 0 58.46 58.46 58.46 58.46 58.46 58.46 Initial Eval 70 min 99223 RC facility inpatient/physician 204 0 101.69 194.11 166.24 162.57 162.57 162.57 194.11 154.77 154.77 101.69