hospital_Sonora Behaviroal Health last_updated_ 2023-12-31 version_1 "hospital_Tucson, Arizona" hospital_address 6050 North Corona Road license_SH4089 |AZ "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_AARP MEDICARE SUPPLEMENT COMMERCIAL] standard_charge|[payer_AARP MEDICARE SUPPLEMENT COMMERCIAL] |percent standard_charge|[payer_AARP MEDICARE SUPPLEMENT COMMERCIAL] |contracting_method additional_payer_notes |[payer_AARP MEDICARE SUPPLEMENT COMMERCIAL] standard_charge|[payer_AETNA HMO/PPO] standard_charge|[payer_AETNA HMO/PPO] |percent standard_charge|[payer_AETNA HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA HMO/PPO] standard_charge|[payer_AETNA MEDICARE MANAGED MEDICARE] standard_charge|[payer_AETNA MEDICARE MANAGED MEDICARE] |percent standard_charge|[payer_AETNA MEDICARE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA MEDICARE MANAGED MEDICARE] standard_charge|[payer_AHCCCS FEDERAL EMERG MEDICAID ] standard_charge|[payer_AHCCCS FEDERAL EMERG MEDICAID ] |percent standard_charge|[payer_AHCCCS FEDERAL EMERG MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS FEDERAL EMERG MEDICAID ] standard_charge|[payer_AHCCCS FFS MEDICAID ] standard_charge|[payer_AHCCCS FFS MEDICAID ] |percent standard_charge|[payer_AHCCCS FFS MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS FFS MEDICAID ] standard_charge|[payer_AHCCCS IHS MEDICAID ] standard_charge|[payer_AHCCCS IHS MEDICAID ] |percent standard_charge|[payer_AHCCCS IHS MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS IHS MEDICAID ] standard_charge|[payer_AHCCCS PENDING PENDING MEDICAID] standard_charge|[payer_AHCCCS PENDING PENDING MEDICAID] |percent standard_charge|[payer_AHCCCS PENDING PENDING MEDICAID] |contracting_method additional_payer_notes |[payer_AHCCCS PENDING PENDING MEDICAID] standard_charge|[payer_ALLEGIANCE COMMERCIAL] standard_charge|[payer_ALLEGIANCE COMMERCIAL] |percent standard_charge|[payer_ALLEGIANCE COMMERCIAL] |contracting_method additional_payer_notes |[payer_ALLEGIANCE COMMERCIAL] standard_charge|[payer_ALLIANCE COMMERCIAL] standard_charge|[payer_ALLIANCE COMMERCIAL] |percent standard_charge|[payer_ALLIANCE COMMERCIAL] |contracting_method additional_payer_notes |[payer_ALLIANCE COMMERCIAL] standard_charge|[payer_ALLIED BENEFITS COMMERCIAL] standard_charge|[payer_ALLIED BENEFITS COMMERCIAL] |percent standard_charge|[payer_ALLIED BENEFITS COMMERCIAL] |contracting_method additional_payer_notes |[payer_ALLIED BENEFITS COMMERCIAL] standard_charge|[payer_ALLWELL FROM AZ COMP MANAGED MEDICARE] standard_charge|[payer_ALLWELL FROM AZ COMP MANAGED MEDICARE] |percent standard_charge|[payer_ALLWELL FROM AZ COMP MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_ALLWELL FROM AZ COMP MANAGED MEDICARE] standard_charge|[payer_ALORICA COMMERCIAL] standard_charge|[payer_ALORICA COMMERCIAL] |percent standard_charge|[payer_ALORICA COMMERCIAL] |contracting_method additional_payer_notes |[payer_ALORICA COMMERCIAL] standard_charge|[payer_AMBETTER HMO/PPO] standard_charge|[payer_AMBETTER HMO/PPO] |percent standard_charge|[payer_AMBETTER HMO/PPO] |contracting_method additional_payer_notes |[payer_AMBETTER HMO/PPO] standard_charge|[payer_ARGUS COMMERCIAL] standard_charge|[payer_ARGUS COMMERCIAL] |percent standard_charge|[payer_ARGUS COMMERCIAL] |contracting_method additional_payer_notes |[payer_ARGUS COMMERCIAL] standard_charge|[payer_ARIZ FOUNDATION HMO/PPO] standard_charge|[payer_ARIZ FOUNDATION HMO/PPO] |percent standard_charge|[payer_ARIZ FOUNDATION HMO/PPO] |contracting_method additional_payer_notes |[payer_ARIZ FOUNDATION HMO/PPO] standard_charge|[payer_AZ COMPLETE HEALTH MANAGED MEDICAID] standard_charge|[payer_AZ COMPLETE HEALTH MANAGED MEDICAID] |percent standard_charge|[payer_AZ COMPLETE HEALTH MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AZ COMPLETE HEALTH MANAGED MEDICAID] standard_charge|[payer_BANNER UNIV CARE ADVANTAG MANAGED MEDICARE] standard_charge|[payer_BANNER UNIV CARE ADVANTAG MANAGED MEDICARE] |percent standard_charge|[payer_BANNER UNIV CARE ADVANTAG MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BANNER UNIV CARE ADVANTAG MANAGED MEDICARE] standard_charge|[payer_BANNER UNIV FAMILY CARE MANAGED MEDICAID] standard_charge|[payer_BANNER UNIV FAMILY CARE MANAGED MEDICAID] |percent standard_charge|[payer_BANNER UNIV FAMILY CARE MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BANNER UNIV FAMILY CARE MANAGED MEDICAID] standard_charge|[payer_BCBS ARIZONA BLUE CROSS] standard_charge|[payer_BCBS ARIZONA BLUE CROSS] |percent standard_charge|[payer_BCBS ARIZONA BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS ARIZONA BLUE CROSS] standard_charge|[payer_BCBS CORP HEALTH BLUE CROSS] standard_charge|[payer_BCBS CORP HEALTH BLUE CROSS] |percent standard_charge|[payer_BCBS CORP HEALTH BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS CORP HEALTH BLUE CROSS] standard_charge|[payer_BCBS FEDERAL BLUE CROSS] standard_charge|[payer_BCBS FEDERAL BLUE CROSS] |percent standard_charge|[payer_BCBS FEDERAL BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS FEDERAL BLUE CROSS] standard_charge|[payer_BCBS MDCR ADVANTAGE MANAGED MEDICARE] standard_charge|[payer_BCBS MDCR ADVANTAGE MANAGED MEDICARE] |percent standard_charge|[payer_BCBS MDCR ADVANTAGE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BCBS MDCR ADVANTAGE MANAGED MEDICARE] standard_charge|[payer_BCBS OF NEW MEXICO MCD MEDICAID: OUT OF STATE] standard_charge|[payer_BCBS OF NEW MEXICO MCD MEDICAID: OUT OF STATE] |percent standard_charge|[payer_BCBS OF NEW MEXICO MCD MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_BCBS OF NEW MEXICO 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_BOON GROUP COMMERCIAL] standard_charge|[payer_BOON GROUP COMMERCIAL] |percent standard_charge|[payer_BOON GROUP COMMERCIAL] |contracting_method additional_payer_notes |[payer_BOON GROUP COMMERCIAL] standard_charge|[payer_BRIGHT HEALTH HMO/PPO] standard_charge|[payer_BRIGHT HEALTH HMO/PPO] |percent standard_charge|[payer_BRIGHT HEALTH HMO/PPO] |contracting_method additional_payer_notes |[payer_BRIGHT HEALTH HMO/PPO] standard_charge|[payer_CARE 1ST HEALTH PLAN MANAGED MEDICAID] standard_charge|[payer_CARE 1ST HEALTH PLAN MANAGED MEDICAID] |percent standard_charge|[payer_CARE 1ST HEALTH PLAN MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_CARE 1ST HEALTH PLAN MANAGED MEDICAID] standard_charge|[payer_CAREMORE MEDICARE MANAGED MEDICARE] standard_charge|[payer_CAREMORE MEDICARE MANAGED MEDICARE] |percent standard_charge|[payer_CAREMORE MEDICARE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CAREMORE MEDICARE MANAGED MEDICARE] standard_charge|[payer_CARESOURCE COMMERCIAL] standard_charge|[payer_CARESOURCE COMMERCIAL] |percent standard_charge|[payer_CARESOURCE COMMERCIAL] |contracting_method additional_payer_notes |[payer_CARESOURCE COMMERCIAL] standard_charge|[payer_CENTURY HEALTHCARE COMMERCIAL] standard_charge|[payer_CENTURY HEALTHCARE COMMERCIAL] |percent standard_charge|[payer_CENTURY HEALTHCARE COMMERCIAL] |contracting_method additional_payer_notes |[payer_CENTURY HEALTHCARE COMMERCIAL] standard_charge|[payer_CHAMP VA VETERANS ADMIN] standard_charge|[payer_CHAMP VA VETERANS ADMIN] |percent standard_charge|[payer_CHAMP VA VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_CHAMP VA VETERANS ADMIN] standard_charge|[payer_CIGNA HMO/PPO] standard_charge|[payer_CIGNA HMO/PPO] |percent standard_charge|[payer_CIGNA HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA HMO/PPO] standard_charge|[payer_CIGNA MEDICARE MANAGED MEDICARE] standard_charge|[payer_CIGNA MEDICARE MANAGED MEDICARE] |percent standard_charge|[payer_CIGNA MEDICARE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CIGNA MEDICARE MANAGED MEDICARE] standard_charge|[payer_CLOVER HEALTH CHOICE MC MANAGED MEDICARE] standard_charge|[payer_CLOVER HEALTH CHOICE MC MANAGED MEDICARE] |percent standard_charge|[payer_CLOVER HEALTH CHOICE MC MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CLOVER HEALTH CHOICE MC MANAGED MEDICARE] standard_charge|[payer_CMDP MANAGED MEDICAID] standard_charge|[payer_CMDP MANAGED MEDICAID] |percent standard_charge|[payer_CMDP MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_CMDP MANAGED MEDICAID] standard_charge|[payer_COCHISE COUNTY TITLE 36 LOCAL GOVT] standard_charge|[payer_COCHISE COUNTY TITLE 36 LOCAL GOVT] |percent standard_charge|[payer_COCHISE COUNTY TITLE 36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_COCHISE COUNTY TITLE 36 LOCAL GOVT] standard_charge|[payer_COFINITY COMMERCIAL] standard_charge|[payer_COFINITY COMMERCIAL] |percent standard_charge|[payer_COFINITY COMMERCIAL] |contracting_method additional_payer_notes |[payer_COFINITY COMMERCIAL] standard_charge|[payer_COMMONWEALTH CARE ALLIANC MANAGED MEDICARE] standard_charge|[payer_COMMONWEALTH CARE ALLIANC MANAGED MEDICARE] |percent standard_charge|[payer_COMMONWEALTH CARE ALLIANC MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_COMMONWEALTH CARE ALLIANC MANAGED MEDICARE] standard_charge|[payer_COMP PSYCH COMMERCIAL] standard_charge|[payer_COMP PSYCH COMMERCIAL] |percent standard_charge|[payer_COMP PSYCH COMMERCIAL] |contracting_method additional_payer_notes |[payer_COMP PSYCH COMMERCIAL] standard_charge|[payer_CONDUENT STATE HEALTHCARE MEDICAID: OUT OF STATE] standard_charge|[payer_CONDUENT STATE HEALTHCARE MEDICAID: OUT OF STATE] |percent standard_charge|[payer_CONDUENT STATE HEALTHCARE MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_CONDUENT STATE HEALTHCARE MEDICAID: OUT OF STATE] standard_charge|[payer_CONNECTICARE COMMERCIAL] standard_charge|[payer_CONNECTICARE COMMERCIAL] |percent standard_charge|[payer_CONNECTICARE COMMERCIAL] |contracting_method additional_payer_notes |[payer_CONNECTICARE COMMERCIAL] standard_charge|[payer_CONSOLIDATED HEALTH PLAN COMMERCIAL] standard_charge|[payer_CONSOLIDATED HEALTH PLAN COMMERCIAL] |percent standard_charge|[payer_CONSOLIDATED HEALTH PLAN COMMERCIAL] |contracting_method additional_payer_notes |[payer_CONSOLIDATED HEALTH PLAN COMMERCIAL] standard_charge|[payer_CONTINENTAL BENEFITS COMMERCIAL] standard_charge|[payer_CONTINENTAL BENEFITS COMMERCIAL] |percent standard_charge|[payer_CONTINENTAL BENEFITS COMMERCIAL] |contracting_method additional_payer_notes |[payer_CONTINENTAL BENEFITS COMMERCIAL] standard_charge|[payer_DCS ACYF LOCAL GOVT] standard_charge|[payer_DCS ACYF LOCAL GOVT] |percent standard_charge|[payer_DCS ACYF LOCAL GOVT] |contracting_method additional_payer_notes |[payer_DCS ACYF LOCAL GOVT] standard_charge|[payer_DCS CHP MERCY CARE MANAGED MEDICAID] standard_charge|[payer_DCS CHP MERCY CARE MANAGED MEDICAID] |percent standard_charge|[payer_DCS CHP MERCY CARE MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_DCS CHP MERCY CARE MANAGED MEDICAID] standard_charge|[payer_DEAN HEALTH PLAN COMMERCIAL] standard_charge|[payer_DEAN HEALTH PLAN COMMERCIAL] |percent standard_charge|[payer_DEAN HEALTH PLAN COMMERCIAL] |contracting_method additional_payer_notes |[payer_DEAN HEALTH PLAN COMMERCIAL] standard_charge|[payer_EBMS COMMERCIAL] standard_charge|[payer_EBMS COMMERCIAL] |percent standard_charge|[payer_EBMS COMMERCIAL] |contracting_method additional_payer_notes |[payer_EBMS COMMERCIAL] standard_charge|[payer_FIRST HEALTH COMMERCIAL] standard_charge|[payer_FIRST HEALTH COMMERCIAL] |percent standard_charge|[payer_FIRST HEALTH COMMERCIAL] |contracting_method additional_payer_notes |[payer_FIRST HEALTH COMMERCIAL] standard_charge|[payer_FIRST HEALTH HMO/PPO] standard_charge|[payer_FIRST HEALTH HMO/PPO] |percent standard_charge|[payer_FIRST HEALTH HMO/PPO] |contracting_method additional_payer_notes |[payer_FIRST HEALTH HMO/PPO] standard_charge|[payer_FT DEFIANCE LOCAL GOVT] standard_charge|[payer_FT DEFIANCE LOCAL GOVT] |percent standard_charge|[payer_FT DEFIANCE LOCAL GOVT] |contracting_method additional_payer_notes |[payer_FT DEFIANCE LOCAL GOVT] standard_charge|[payer_GEHA ASA HMO/PPO] standard_charge|[payer_GEHA ASA HMO/PPO] |percent standard_charge|[payer_GEHA ASA HMO/PPO] |contracting_method additional_payer_notes |[payer_GEHA ASA HMO/PPO] standard_charge|[payer_GEHA FEHB HMO/PPO] standard_charge|[payer_GEHA FEHB HMO/PPO] |percent standard_charge|[payer_GEHA FEHB HMO/PPO] |contracting_method additional_payer_notes |[payer_GEHA FEHB HMO/PPO] standard_charge|[payer_GILA COUNTY FINANCE DEPT LOCAL GOVT] standard_charge|[payer_GILA COUNTY FINANCE DEPT LOCAL GOVT] |percent standard_charge|[payer_GILA COUNTY FINANCE DEPT LOCAL GOVT] |contracting_method additional_payer_notes |[payer_GILA COUNTY FINANCE DEPT LOCAL GOVT] standard_charge|[payer_GILA RIVER IHS HEALTHCARE COMMERCIAL] standard_charge|[payer_GILA RIVER IHS HEALTHCARE COMMERCIAL] |percent standard_charge|[payer_GILA RIVER IHS HEALTHCARE COMMERCIAL] |contracting_method additional_payer_notes |[payer_GILA RIVER IHS HEALTHCARE COMMERCIAL] standard_charge|[payer_GILA RIVER T36 TRIBE LOCAL GOVT] standard_charge|[payer_GILA RIVER T36 TRIBE LOCAL GOVT] |percent standard_charge|[payer_GILA RIVER T36 TRIBE LOCAL GOVT] |contracting_method additional_payer_notes |[payer_GILA RIVER T36 TRIBE LOCAL GOVT] standard_charge|[payer_GOLDEN RULE UHC HMO/PPO] standard_charge|[payer_GOLDEN RULE UHC HMO/PPO] |percent standard_charge|[payer_GOLDEN RULE UHC HMO/PPO] |contracting_method additional_payer_notes |[payer_GOLDEN RULE UHC HMO/PPO] standard_charge|[payer_GRAHAM CNTY TITLE 36 LOCAL GOVT] standard_charge|[payer_GRAHAM CNTY TITLE 36 LOCAL GOVT] |percent standard_charge|[payer_GRAHAM CNTY TITLE 36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_GRAHAM CNTY TITLE 36 LOCAL GOVT] standard_charge|[payer_GREAT WEST COMMERCIAL] standard_charge|[payer_GREAT WEST COMMERCIAL] |percent standard_charge|[payer_GREAT WEST COMMERCIAL] |contracting_method additional_payer_notes |[payer_GREAT WEST COMMERCIAL] standard_charge|[payer_GREAT WEST HMO/PPO] standard_charge|[payer_GREAT WEST HMO/PPO] |percent standard_charge|[payer_GREAT WEST HMO/PPO] |contracting_method additional_payer_notes |[payer_GREAT WEST HMO/PPO] standard_charge|[payer_GREENLEE COUNTY T36 LOCAL GOVT] standard_charge|[payer_GREENLEE COUNTY T36 LOCAL GOVT] |percent standard_charge|[payer_GREENLEE COUNTY T36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_GREENLEE COUNTY T36 LOCAL GOVT] standard_charge|[payer_GROUP PENSION ADMIN COMMERCIAL] standard_charge|[payer_GROUP PENSION ADMIN COMMERCIAL] |percent standard_charge|[payer_GROUP PENSION ADMIN COMMERCIAL] |contracting_method additional_payer_notes |[payer_GROUP PENSION ADMIN COMMERCIAL] standard_charge|[payer_HEALTH COMP COMMERCIAL] standard_charge|[payer_HEALTH COMP COMMERCIAL] |percent standard_charge|[payer_HEALTH COMP COMMERCIAL] |contracting_method additional_payer_notes |[payer_HEALTH COMP COMMERCIAL] standard_charge|[payer_HEALTH FIRST COMMERCIAL] standard_charge|[payer_HEALTH FIRST COMMERCIAL] |percent standard_charge|[payer_HEALTH FIRST COMMERCIAL] |contracting_method additional_payer_notes |[payer_HEALTH FIRST COMMERCIAL] standard_charge|[payer_HEALTHCHOICE AZ MANAGED MEDICAID] standard_charge|[payer_HEALTHCHOICE AZ MANAGED MEDICAID] |percent standard_charge|[payer_HEALTHCHOICE AZ MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_HEALTHCHOICE AZ MANAGED MEDICAID] standard_charge|[payer_HEALTHCHOICE MEDICARE MANAGED MEDICARE] standard_charge|[payer_HEALTHCHOICE MEDICARE MANAGED MEDICARE] |percent standard_charge|[payer_HEALTHCHOICE MEDICARE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HEALTHCHOICE MEDICARE MANAGED MEDICARE] standard_charge|[payer_HELMSMAN MANAGEMENT SERVI COMMERCIAL] standard_charge|[payer_HELMSMAN MANAGEMENT SERVI COMMERCIAL] |percent standard_charge|[payer_HELMSMAN MANAGEMENT SERVI COMMERCIAL] |contracting_method additional_payer_notes |[payer_HELMSMAN MANAGEMENT SERVI COMMERCIAL] standard_charge|[payer_HMA NAVAJO NATION EMP LOCAL GOVT] standard_charge|[payer_HMA NAVAJO NATION EMP LOCAL GOVT] |percent standard_charge|[payer_HMA NAVAJO NATION EMP LOCAL GOVT] |contracting_method additional_payer_notes |[payer_HMA NAVAJO NATION EMP LOCAL GOVT] standard_charge|[payer_HMC HEALTH WORKS HMO/PPO] standard_charge|[payer_HMC HEALTH WORKS HMO/PPO] |percent standard_charge|[payer_HMC HEALTH WORKS HMO/PPO] |contracting_method additional_payer_notes |[payer_HMC HEALTH WORKS HMO/PPO] standard_charge|[payer_HOLMAN GROUP HMO/PPO] standard_charge|[payer_HOLMAN GROUP HMO/PPO] |percent standard_charge|[payer_HOLMAN GROUP HMO/PPO] |contracting_method additional_payer_notes |[payer_HOLMAN GROUP HMO/PPO] standard_charge|[payer_HOPI HEALTH CARE CENTER LOCAL GOVT] standard_charge|[payer_HOPI HEALTH CARE CENTER LOCAL GOVT] |percent standard_charge|[payer_HOPI HEALTH CARE CENTER LOCAL GOVT] |contracting_method additional_payer_notes |[payer_HOPI HEALTH CARE CENTER LOCAL GOVT] standard_charge|[payer_HUMANA HMO/PPO] standard_charge|[payer_HUMANA HMO/PPO] |percent standard_charge|[payer_HUMANA HMO/PPO] |contracting_method additional_payer_notes |[payer_HUMANA HMO/PPO] standard_charge|[payer_HUMANA GOLD MEDICARE MANAGED MEDICARE] standard_charge|[payer_HUMANA GOLD MEDICARE MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA GOLD MEDICARE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA GOLD MEDICARE MANAGED MEDICARE] standard_charge|[payer_ICE LOCAL GOVT] standard_charge|[payer_ICE LOCAL GOVT] |percent standard_charge|[payer_ICE LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ICE LOCAL GOVT] standard_charge|[payer_IEHP HEALTH ACCESS MANAGED MEDICARE] standard_charge|[payer_IEHP HEALTH ACCESS MANAGED MEDICARE] |percent standard_charge|[payer_IEHP HEALTH ACCESS MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_IEHP HEALTH ACCESS MANAGED MEDICARE] standard_charge|[payer_IHS CONTRACT SERVICES LOCAL GOVT] standard_charge|[payer_IHS CONTRACT SERVICES LOCAL GOVT] |percent standard_charge|[payer_IHS CONTRACT SERVICES LOCAL GOVT] |contracting_method additional_payer_notes |[payer_IHS CONTRACT SERVICES LOCAL GOVT] standard_charge|[payer_IHS TOHONO OODHAM NATION COMMERCIAL] standard_charge|[payer_IHS TOHONO OODHAM NATION COMMERCIAL] |percent standard_charge|[payer_IHS TOHONO OODHAM NATION COMMERCIAL] |contracting_method additional_payer_notes |[payer_IHS TOHONO OODHAM NATION COMMERCIAL] standard_charge|[payer_KAISER PERMANENTE COMMERCIAL] standard_charge|[payer_KAISER PERMANENTE COMMERCIAL] |percent standard_charge|[payer_KAISER PERMANENTE COMMERCIAL] |contracting_method additional_payer_notes |[payer_KAISER PERMANENTE COMMERCIAL] standard_charge|[payer_LIFE SHIELD STM COMMERCIAL] standard_charge|[payer_LIFE SHIELD STM COMMERCIAL] |percent standard_charge|[payer_LIFE SHIELD STM COMMERCIAL] |contracting_method additional_payer_notes |[payer_LIFE SHIELD STM COMMERCIAL] standard_charge|[payer_MAGELLAN HMO/PPO] standard_charge|[payer_MAGELLAN HMO/PPO] |percent standard_charge|[payer_MAGELLAN HMO/PPO] |contracting_method additional_payer_notes |[payer_MAGELLAN HMO/PPO] standard_charge|[payer_MARICOPA CTY T36 LOCAL GOVT] standard_charge|[payer_MARICOPA CTY T36 LOCAL GOVT] |percent standard_charge|[payer_MARICOPA CTY T36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MARICOPA CTY T36 LOCAL GOVT] standard_charge|[payer_MEDICARE MEDICARE] standard_charge|[payer_MEDICARE MEDICARE] |percent standard_charge|[payer_MEDICARE MEDICARE] |contracting_method additional_payer_notes |[payer_MEDICARE MEDICARE] standard_charge|[payer_MERCY CARE MEDICARE MANAGED MEDICARE] standard_charge|[payer_MERCY CARE MEDICARE MANAGED MEDICARE] |percent standard_charge|[payer_MERCY CARE MEDICARE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MERCY CARE MEDICARE MANAGED MEDICARE] standard_charge|[payer_MERCY CARE PLAN MANAGED MEDICAID] standard_charge|[payer_MERCY CARE PLAN MANAGED MEDICAID] |percent standard_charge|[payer_MERCY CARE PLAN MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MERCY CARE PLAN MANAGED MEDICAID] standard_charge|[payer_MERCY MARICOPA RBHA MANAGED MEDICAID] standard_charge|[payer_MERCY MARICOPA RBHA MANAGED MEDICAID] |percent standard_charge|[payer_MERCY MARICOPA RBHA MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MERCY MARICOPA RBHA MANAGED MEDICAID] standard_charge|[payer_MERITAIN COMMERCIAL] standard_charge|[payer_MERITAIN COMMERCIAL] |percent standard_charge|[payer_MERITAIN COMMERCIAL] |contracting_method additional_payer_notes |[payer_MERITAIN COMMERCIAL] standard_charge|[payer_MERITAIN HMO/PPO] standard_charge|[payer_MERITAIN HMO/PPO] |percent standard_charge|[payer_MERITAIN HMO/PPO] |contracting_method additional_payer_notes |[payer_MERITAIN HMO/PPO] standard_charge|[payer_MHN MANAGED HEALTH NETWOR HMO/PPO] standard_charge|[payer_MHN MANAGED HEALTH NETWOR HMO/PPO] |percent standard_charge|[payer_MHN MANAGED HEALTH NETWOR HMO/PPO] |contracting_method additional_payer_notes |[payer_MHN MANAGED HEALTH NETWOR HMO/PPO] standard_charge|[payer_MHN MEDICARE MANAGED MEDICARE] standard_charge|[payer_MHN MEDICARE MANAGED MEDICARE] |percent standard_charge|[payer_MHN MEDICARE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MHN MEDICARE MANAGED MEDICARE] standard_charge|[payer_MINES AND ASSOCIATES HMO/PPO] standard_charge|[payer_MINES AND ASSOCIATES HMO/PPO] |percent standard_charge|[payer_MINES AND ASSOCIATES HMO/PPO] |contracting_method additional_payer_notes |[payer_MINES AND ASSOCIATES HMO/PPO] standard_charge|[payer_MISC INSURANCE COMMERCIAL] standard_charge|[payer_MISC INSURANCE COMMERCIAL] |percent standard_charge|[payer_MISC INSURANCE COMMERCIAL] |contracting_method additional_payer_notes |[payer_MISC INSURANCE COMMERCIAL] standard_charge|[payer_MOLINA COMPLETE CARE MANAGED MEDICAID] standard_charge|[payer_MOLINA COMPLETE CARE MANAGED MEDICAID] |percent standard_charge|[payer_MOLINA COMPLETE CARE MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MOLINA COMPLETE CARE MANAGED MEDICAID] standard_charge|[payer_MOLINA HEALTHCARE OF NM MEDICAID: OUT OF STATE] standard_charge|[payer_MOLINA HEALTHCARE OF NM MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MOLINA HEALTHCARE OF NM MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MOLINA HEALTHCARE OF NM 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_NAVAJO NATION T36 LOCAL GOVT] standard_charge|[payer_NAVAJO NATION T36 LOCAL GOVT] |percent standard_charge|[payer_NAVAJO NATION T36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_NAVAJO NATION T36 LOCAL GOVT] standard_charge|[payer_ONECARE MEDICARE ADVANT MANAGED MEDICARE] standard_charge|[payer_ONECARE MEDICARE ADVANT MANAGED MEDICARE] |percent standard_charge|[payer_ONECARE MEDICARE ADVANT MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_ONECARE MEDICARE ADVANT MANAGED MEDICARE] standard_charge|[payer_OUT OF STATE MEDICAID MEDICAID: OUT OF STATE] standard_charge|[payer_OUT OF STATE MEDICAID MEDICAID: OUT OF STATE] |percent standard_charge|[payer_OUT OF STATE MEDICAID MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_OUT OF STATE MEDICAID MEDICAID: OUT OF STATE] standard_charge|[payer_P3 AZ HEALTH PARTNERS MANAGED MEDICARE] standard_charge|[payer_P3 AZ HEALTH PARTNERS MANAGED MEDICARE] |percent standard_charge|[payer_P3 AZ HEALTH PARTNERS MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_P3 AZ HEALTH PARTNERS MANAGED MEDICARE] standard_charge|[payer_PACIFICSOURCE COMMERCIAL] standard_charge|[payer_PACIFICSOURCE COMMERCIAL] |percent standard_charge|[payer_PACIFICSOURCE COMMERCIAL] |contracting_method additional_payer_notes |[payer_PACIFICSOURCE COMMERCIAL] standard_charge|[payer_PIMA COUNTY T36 LOCAL GOVT] standard_charge|[payer_PIMA COUNTY T36 LOCAL GOVT] |percent standard_charge|[payer_PIMA COUNTY T36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_PIMA COUNTY T36 LOCAL GOVT] standard_charge|[payer_PINAL CNTY TITLE 36 LOCAL GOVT] standard_charge|[payer_PINAL CNTY TITLE 36 LOCAL GOVT] |percent standard_charge|[payer_PINAL CNTY TITLE 36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_PINAL CNTY TITLE 36 LOCAL GOVT] standard_charge|[payer_POINT COMFORT UNDERWRITER COMMERCIAL] standard_charge|[payer_POINT COMFORT UNDERWRITER COMMERCIAL] |percent standard_charge|[payer_POINT COMFORT UNDERWRITER COMMERCIAL] |contracting_method additional_payer_notes |[payer_POINT COMFORT UNDERWRITER COMMERCIAL] standard_charge|[payer_PREFERRED ONE COMMERCIAL] standard_charge|[payer_PREFERRED ONE COMMERCIAL] |percent standard_charge|[payer_PREFERRED ONE COMMERCIAL] |contracting_method additional_payer_notes |[payer_PREFERRED ONE COMMERCIAL] standard_charge|[payer_PRESBYTERIAN CENTENNIAL MEDICAID: OUT OF STATE] standard_charge|[payer_PRESBYTERIAN CENTENNIAL MEDICAID: OUT OF STATE] |percent standard_charge|[payer_PRESBYTERIAN CENTENNIAL MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_PRESBYTERIAN CENTENNIAL MEDICAID: OUT OF STATE] standard_charge|[payer_PROVIDENCE HEALTH PLAN HMO/PPO] standard_charge|[payer_PROVIDENCE HEALTH PLAN HMO/PPO] |percent standard_charge|[payer_PROVIDENCE HEALTH PLAN HMO/PPO] |contracting_method additional_payer_notes |[payer_PROVIDENCE HEALTH PLAN HMO/PPO] standard_charge|[payer_SAN CARLOS APACHE HEALTH LOCAL GOVT] standard_charge|[payer_SAN CARLOS APACHE HEALTH LOCAL GOVT] |percent standard_charge|[payer_SAN CARLOS APACHE HEALTH LOCAL GOVT] |contracting_method additional_payer_notes |[payer_SAN CARLOS APACHE HEALTH LOCAL GOVT] standard_charge|[payer_SANTA CRUZ CTY T36 LOCAL GOVT] standard_charge|[payer_SANTA CRUZ CTY T36 LOCAL GOVT] |percent standard_charge|[payer_SANTA CRUZ CTY T36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_SANTA CRUZ CTY T36 LOCAL GOVT] standard_charge|[payer_SAVAHCS VETERANS ADMIN] standard_charge|[payer_SAVAHCS VETERANS ADMIN] |percent standard_charge|[payer_SAVAHCS VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_SAVAHCS VETERANS ADMIN] standard_charge|[payer_SUMMIT COMMERCIAL] standard_charge|[payer_SUMMIT COMMERCIAL] |percent standard_charge|[payer_SUMMIT COMMERCIAL] |contracting_method additional_payer_notes |[payer_SUMMIT COMMERCIAL] standard_charge|[payer_TRBHA APACHE SAN CARLOS MEDICAID ] standard_charge|[payer_TRBHA APACHE SAN CARLOS MEDICAID ] |percent standard_charge|[payer_TRBHA APACHE SAN CARLOS MEDICAID ] |contracting_method additional_payer_notes |[payer_TRBHA APACHE SAN CARLOS MEDICAID ] standard_charge|[payer_TRBHA APACHE WHITE MTN MEDICAID ] standard_charge|[payer_TRBHA APACHE WHITE MTN MEDICAID ] |percent standard_charge|[payer_TRBHA APACHE WHITE MTN MEDICAID ] |contracting_method additional_payer_notes |[payer_TRBHA APACHE WHITE MTN MEDICAID ] standard_charge|[payer_TRBHA GILA RIVER MEDICAID ] standard_charge|[payer_TRBHA GILA RIVER MEDICAID ] |percent standard_charge|[payer_TRBHA GILA RIVER MEDICAID ] |contracting_method additional_payer_notes |[payer_TRBHA GILA RIVER MEDICAID ] standard_charge|[payer_TRBHA HOPI MEDICAID ] standard_charge|[payer_TRBHA HOPI MEDICAID ] |percent standard_charge|[payer_TRBHA HOPI MEDICAID ] |contracting_method additional_payer_notes |[payer_TRBHA HOPI MEDICAID ] standard_charge|[payer_TRBHA NAVAJO MEDICAID ] standard_charge|[payer_TRBHA NAVAJO MEDICAID ] |percent standard_charge|[payer_TRBHA NAVAJO MEDICAID ] |contracting_method additional_payer_notes |[payer_TRBHA NAVAJO MEDICAID ] standard_charge|[payer_TRBHA PASCUA YAQUI MEDICAID ] standard_charge|[payer_TRBHA PASCUA YAQUI MEDICAID ] |percent standard_charge|[payer_TRBHA PASCUA YAQUI MEDICAID ] |contracting_method additional_payer_notes |[payer_TRBHA PASCUA YAQUI MEDICAID ] standard_charge|[payer_TRBHA TOHONO O ODHAM MEDICAID ] standard_charge|[payer_TRBHA TOHONO O ODHAM MEDICAID ] |percent standard_charge|[payer_TRBHA TOHONO O ODHAM MEDICAID ] |contracting_method additional_payer_notes |[payer_TRBHA TOHONO O ODHAM MEDICAID ] standard_charge|[payer_TRICARE EAST HUMANA TRICARE] standard_charge|[payer_TRICARE EAST HUMANA TRICARE] |percent standard_charge|[payer_TRICARE EAST HUMANA TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE EAST HUMANA TRICARE] standard_charge|[payer_TRICARE FOR LIFE TRICARE] standard_charge|[payer_TRICARE FOR LIFE TRICARE] |percent standard_charge|[payer_TRICARE FOR LIFE TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE FOR LIFE TRICARE] standard_charge|[payer_TRICARE WEST TRICARE] standard_charge|[payer_TRICARE WEST TRICARE] |percent standard_charge|[payer_TRICARE WEST TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE WEST TRICARE] 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_UHC COMMUNITY PLAN MANAGED MEDICAID] standard_charge|[payer_UHC COMMUNITY PLAN MANAGED MEDICAID] |percent standard_charge|[payer_UHC COMMUNITY PLAN MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_UHC COMMUNITY PLAN MANAGED MEDICAID] standard_charge|[payer_UHC DUAL COMPLETE MANAGED MEDICARE] standard_charge|[payer_UHC DUAL COMPLETE MANAGED MEDICARE] |percent standard_charge|[payer_UHC DUAL COMPLETE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UHC DUAL COMPLETE MANAGED MEDICARE] standard_charge|[payer_UHC SHARED SERVICES HMO/PPO] standard_charge|[payer_UHC SHARED SERVICES HMO/PPO] |percent standard_charge|[payer_UHC SHARED SERVICES HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC SHARED SERVICES HMO/PPO] standard_charge|[payer_UNITED BEHAVIORAL HEALTH HMO/PPO] standard_charge|[payer_UNITED BEHAVIORAL HEALTH HMO/PPO] |percent standard_charge|[payer_UNITED BEHAVIORAL HEALTH HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED BEHAVIORAL HEALTH HMO/PPO] standard_charge|[payer_UNITED MEDICAL RESOURCES HMO/PPO] standard_charge|[payer_UNITED MEDICAL RESOURCES HMO/PPO] |percent standard_charge|[payer_UNITED MEDICAL RESOURCES HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED MEDICAL RESOURCES HMO/PPO] standard_charge|[payer_UPMC HEALTH PLAN COMMERCIAL] standard_charge|[payer_UPMC HEALTH PLAN COMMERCIAL] |percent standard_charge|[payer_UPMC HEALTH PLAN COMMERCIAL] |contracting_method additional_payer_notes |[payer_UPMC HEALTH PLAN COMMERCIAL] standard_charge|[payer_WELLCARE MEDICARE MANAGED MEDICARE] standard_charge|[payer_WELLCARE MEDICARE MANAGED MEDICARE] |percent standard_charge|[payer_WELLCARE MEDICARE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_WELLCARE MEDICARE MANAGED MEDICARE] standard_charge|[payer_WINDOW ROCK T36 LOCAL GOVT] standard_charge|[payer_WINDOW ROCK T36 LOCAL GOVT] |percent standard_charge|[payer_WINDOW ROCK T36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WINDOW ROCK T36 LOCAL GOVT] standard_charge|[payer_YOEME HEALTH CARE LOCAL GOVT] standard_charge|[payer_YOEME HEALTH CARE LOCAL GOVT] |percent standard_charge|[payer_YOEME HEALTH CARE LOCAL GOVT] |contracting_method additional_payer_notes |[payer_YOEME HEALTH CARE LOCAL GOVT] standard_charge|[payer_YUMA COUNTY TITLE 36 LOCAL GOVT] standard_charge|[payer_YUMA COUNTY TITLE 36 LOCAL GOVT] |percent standard_charge|[payer_YUMA COUNTY TITLE 36 LOCAL GOVT] |contracting_method additional_payer_notes |[payer_YUMA COUNTY TITLE 36 LOCAL GOVT] standard_charge|[payer_YUMA COUNTY VICTIM SERV LOCAL GOVT] standard_charge|[payer_YUMA COUNTY VICTIM SERV LOCAL GOVT] |percent standard_charge|[payer_YUMA COUNTY VICTIM SERV LOCAL GOVT] |contracting_method additional_payer_notes |[payer_YUMA COUNTY VICTIM SERV LOCAL GOVT] ADULT PSYCH SEMI ROOM AND BOARD 124.00 RC facility inpatient 2230.00 850.00 816.39 2230.00 2230.00 per diem 1048.00 per diem 1048.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 816.39 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 950.00 per diem 1023.75 per diem 853.12 per diem 2230.00 per diem 996.00 per diem 2230.00 per diem 1550.32 per diem 853.12 per diem 850.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1124.00 per diem 1124.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1048.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 990.00 per diem 2230.00 per diem 1124.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 925.00 per diem 2230.00 per diem 2230.00 per diem 1030.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1045.00 per diem 2230.00 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 1181.00 per diem 1345.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 940.00 per diem 1050.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1100.00 per diem 2230.00 per diem 1045.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 1386.00 per diem 919.00 per diem 870.18 per diem 919.00 per diem 990.00 per diem 990.00 per diem 990.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem CHILD MENTAL HEALTH 124.00 RC facility inpatient 2230.00 850.00 816.39 2230.00 2230.00 per diem 1048.00 per diem 1048.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 816.39 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 950.00 per diem 1023.75 per diem 853.12 per diem 2230.00 per diem 996.00 per diem 2230.00 per diem 1550.32 per diem 853.12 per diem 850.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1124.00 per diem 1124.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1048.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 990.00 per diem 2230.00 per diem 1124.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 925.00 per diem 2230.00 per diem 2230.00 per diem 1030.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1045.00 per diem 2230.00 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 1181.00 per diem 1345.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 940.00 per diem 1050.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1100.00 per diem 2230.00 per diem 1045.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 1386.00 per diem 919.00 per diem 870.18 per diem 919.00 per diem 990.00 per diem 990.00 per diem 990.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem CHILD SEMI PRIV MH 124.00 RC facility inpatient 2230.00 850.00 816.39 2230.00 2230.00 per diem 1048.00 per diem 1048.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 816.39 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 950.00 per diem 1023.75 per diem 853.12 per diem 2230.00 per diem 996.00 per diem 2230.00 per diem 1550.32 per diem 853.12 per diem 850.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1124.00 per diem 1124.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1048.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 990.00 per diem 2230.00 per diem 1124.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 925.00 per diem 2230.00 per diem 2230.00 per diem 1030.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1045.00 per diem 2230.00 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 1181.00 per diem 1345.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 940.00 per diem 1050.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1100.00 per diem 2230.00 per diem 1045.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 1386.00 per diem 919.00 per diem 870.18 per diem 919.00 per diem 990.00 per diem 990.00 per diem 990.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem PSYCH CHILD SEMI ROOM AND BOARD 124.00 RC facility inpatient 2230.00 850.00 816.39 2230.00 2230.00 per diem 1048.00 per diem 1048.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 816.39 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 950.00 per diem 1023.75 per diem 853.12 per diem 2230.00 per diem 996.00 per diem 2230.00 per diem 1550.32 per diem 853.12 per diem 850.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1124.00 per diem 1124.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1048.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 990.00 per diem 2230.00 per diem 1124.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 925.00 per diem 2230.00 per diem 2230.00 per diem 1030.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1045.00 per diem 2230.00 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 1181.00 per diem 1345.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 940.00 per diem 1050.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1100.00 per diem 2230.00 per diem 1045.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 1386.00 per diem 919.00 per diem 870.18 per diem 919.00 per diem 990.00 per diem 990.00 per diem 990.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem PSYCH YOUTH SEMI PVT 124.00 RC facility inpatient 2230.00 850.00 816.39 2230.00 2230.00 per diem 1048.00 per diem 1048.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 816.39 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 950.00 per diem 1023.75 per diem 853.12 per diem 2230.00 per diem 996.00 per diem 2230.00 per diem 1550.32 per diem 853.12 per diem 850.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1124.00 per diem 1124.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1048.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 990.00 per diem 2230.00 per diem 1124.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 925.00 per diem 2230.00 per diem 2230.00 per diem 1030.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1045.00 per diem 2230.00 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 1181.00 per diem 1345.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 940.00 per diem 1050.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1100.00 per diem 2230.00 per diem 1045.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 1386.00 per diem 919.00 per diem 870.18 per diem 919.00 per diem 990.00 per diem 990.00 per diem 990.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem YOUTH MENTAL HEALTH 124.00 RC facility inpatient 2230.00 850.00 816.39 2230.00 2230.00 per diem 1048.00 per diem 1048.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 816.39 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 950.00 per diem 1023.75 per diem 853.12 per diem 2230.00 per diem 996.00 per diem 2230.00 per diem 1550.32 per diem 853.12 per diem 850.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1124.00 per diem 1124.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1048.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 990.00 per diem 2230.00 per diem 1124.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 925.00 per diem 2230.00 per diem 2230.00 per diem 1030.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1045.00 per diem 2230.00 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 1181.00 per diem 1345.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 940.00 per diem 1050.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1100.00 per diem 2230.00 per diem 1045.00 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 853.12 per diem 2230.00 per diem 2230.00 per diem 1386.00 per diem 919.00 per diem 870.18 per diem 919.00 per diem 990.00 per diem 990.00 per diem 990.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem ADULT DETOX SEMI ROOM AND BOARD 126.00 RC facility inpatient 2230.00 850.00 739.87 2230.00 2230.00 per diem 1048.00 per diem 1048.00 per diem 773.16 per diem 773.16 per diem 773.16 per diem 739.87 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 950.00 per diem 927.79 per diem 773.16 per diem 2230.00 per diem 996.00 per diem 2230.00 per diem 1309.15 per diem 773.16 per diem 850.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1124.00 per diem 1124.00 per diem 2230.00 per diem 773.16 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 773.16 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1048.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 990.00 per diem 2230.00 per diem 1124.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 773.16 per diem 2230.00 per diem 2230.00 per diem 925.00 per diem 2230.00 per diem 2230.00 per diem 1030.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 985.00 per diem 2230.00 per diem 773.16 per diem 773.16 per diem 2230.00 per diem 1181.00 per diem 1500.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 940.00 per diem 1050.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 1100.00 per diem 2230.00 per diem 985.00 per diem 773.16 per diem 773.16 per diem 773.16 per diem 773.16 per diem 773.16 per diem 773.16 per diem 773.16 per diem 2230.00 per diem 2230.00 per diem 1386.00 per diem 919.00 per diem 788.62 per diem 919.00 per diem 990.00 per diem 990.00 per diem 990.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem 2230.00 per diem ELECTROCONVULSIVE THERAPY IP 901.00 RC facility inpatient 1380.00 440.00 72.64 2774.00 1380.00 per diem 2096.00 per diem 2096.00 per diem 72.64 per diem 1380.00 per diem 1380.00 per diem 1380.00 per diem 494.95 per diem 1380.00 per diem 950.00 per diem 1724.26 per diem 494.95 per diem 72.64 per diem 393.19 per diem 393.19 per diem 393.19 per diem 494.95 per diem 1168.00 per diem 2774.00 per diem 72.64 per diem 1380.00 per diem 1380.00 per diem 2192.00 per diem 2192.00 per diem 1048.00 per diem 1380.00 per diem 1755.00 per diem 1096.00 per diem 72.64 per diem 1380.00 per diem 1980.00 per diem 494.95 per diem 1380.00 per diem 1380.00 per diem 2076.00 per diem 494.95 per diem 494.95 per diem 72.64 per diem 72.64 per diem 1380.00 per diem 1933.00 per diem 494.95 per diem 1380.00 per diem 1380.00 per diem 1380.00 per diem 2680.00 per diem 1380.00 per diem 1038.00 per diem 72.64 per diem 72.64 per diem 72.64 per diem 72.64 per diem 72.64 per diem 72.64 per diem 72.64 per diem 1380.00 per diem 1380.00 per diem 1685.00 per diem 330.50 per diem 1685.00 per diem 825.00 per diem 1755.00 per diem 1755.00 per diem ELECTROCONVULSIVE THERAPY OP 901.00 RC facility outpatient 1380.00 440.00 72.64 2774.00 1380.00 per diem 2096.00 per diem 2096.00 per diem 72.64 per diem 1380.00 per diem 1380.00 per diem 1380.00 per diem 494.95 per diem 1380.00 per diem 950.00 per diem 1724.26 per diem 494.95 per diem 72.64 per diem 393.19 per diem 393.19 per diem 393.19 per diem 494.95 per diem 1168.00 per diem 2774.00 per diem 72.64 per diem 1380.00 per diem 1380.00 per diem 2192.00 per diem 2192.00 per diem 1048.00 per diem 1380.00 per diem 1755.00 per diem 1096.00 per diem 72.64 per diem 1380.00 per diem 1980.00 per diem 494.95 per diem 1380.00 per diem 1380.00 per diem 2076.00 per diem 494.95 per diem 494.95 per diem 72.64 per diem 72.64 per diem 1380.00 per diem 1933.00 per diem 494.95 per diem 1380.00 per diem 1380.00 per diem 1380.00 per diem 2680.00 per diem 1380.00 per diem 1038.00 per diem 72.64 per diem 72.64 per diem 72.64 per diem 72.64 per diem 72.64 per diem 72.64 per diem 72.64 per diem 1380.00 per diem 1380.00 per diem 1685.00 per diem 330.50 per diem 1685.00 per diem 825.00 per diem 1755.00 per diem 1755.00 per diem INTENSIVE OUTPATIENT PROGRAM ADULT PSY-CENPAT 905.00 RC facility outpatient 671.00 150.00 190.00 671.00 671.00 per diem 243.00 per diem 243.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 671.00 per diem 671.00 per diem 250.00 per diem 204.00 per diem 377.81 per diem 234.90 per diem 234.90 per diem 234.90 per diem 243.00 per diem 373.54 per diem 377.81 per diem 200.00 per diem 671.00 per diem 230.00 per diem 230.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 671.00 per diem 671.00 per diem 190.00 per diem 224.00 per diem 377.81 per diem 265.00 per diem 325.00 per diem 671.00 per diem 274.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 275.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 671.00 per diem 372.00 per diem 190.00 per diem 370.41 per diem 190.00 per diem 190.00 per diem 190.00 per diem INTENSIVE OUTPATIENT PROGRAM MH GROUP ADOL 905.00 RC facility outpatient 671.00 150.00 190.00 671.00 671.00 per diem 243.00 per diem 243.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 671.00 per diem 671.00 per diem 250.00 per diem 204.00 per diem 377.81 per diem 234.90 per diem 234.90 per diem 234.90 per diem 243.00 per diem 373.54 per diem 377.81 per diem 200.00 per diem 671.00 per diem 230.00 per diem 230.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 671.00 per diem 671.00 per diem 190.00 per diem 224.00 per diem 377.81 per diem 265.00 per diem 325.00 per diem 671.00 per diem 274.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 275.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 671.00 per diem 372.00 per diem 190.00 per diem 370.41 per diem 190.00 per diem 190.00 per diem 190.00 per diem INTENSIVE OUTPATIENT PROGRAM MH GROUP ADULT 905.00 RC facility outpatient 671.00 150.00 190.00 671.00 671.00 per diem 243.00 per diem 243.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 671.00 per diem 671.00 per diem 250.00 per diem 204.00 per diem 377.81 per diem 234.90 per diem 234.90 per diem 234.90 per diem 243.00 per diem 373.54 per diem 377.81 per diem 200.00 per diem 671.00 per diem 230.00 per diem 230.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 671.00 per diem 671.00 per diem 190.00 per diem 224.00 per diem 377.81 per diem 265.00 per diem 325.00 per diem 671.00 per diem 274.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 275.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 671.00 per diem 372.00 per diem 190.00 per diem 370.41 per diem 190.00 per diem 190.00 per diem 190.00 per diem INTENSIVE OUTPATIENT PROGRAM MH GRP THERAPY 905.00 RC facility outpatient 224.00 150.00 190.00 671.00 671.00 per diem 243.00 per diem 243.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 671.00 per diem 671.00 per diem 250.00 per diem 204.00 per diem 377.81 per diem 234.90 per diem 234.90 per diem 234.90 per diem 243.00 per diem 373.54 per diem 377.81 per diem 200.00 per diem 671.00 per diem 230.00 per diem 230.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 671.00 per diem 671.00 per diem 190.00 per diem 224.00 per diem 377.81 per diem 265.00 per diem 325.00 per diem 671.00 per diem 274.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 275.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 671.00 per diem 372.00 per diem 190.00 per diem 370.41 per diem 190.00 per diem 190.00 per diem 190.00 per diem TELE INTENSIVE OUTPATIENT PROGRAM MH 905.00 RC facility outpatient 671.00 150.00 190.00 671.00 671.00 per diem 243.00 per diem 243.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 671.00 per diem 671.00 per diem 250.00 per diem 204.00 per diem 377.81 per diem 234.90 per diem 234.90 per diem 234.90 per diem 243.00 per diem 373.54 per diem 377.81 per diem 200.00 per diem 671.00 per diem 230.00 per diem 230.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 671.00 per diem 671.00 per diem 190.00 per diem 224.00 per diem 377.81 per diem 265.00 per diem 325.00 per diem 671.00 per diem 274.00 per diem 377.81 per diem 377.81 per diem 671.00 per diem 275.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 671.00 per diem 372.00 per diem 190.00 per diem 370.41 per diem 190.00 per diem 190.00 per diem 190.00 per diem INTENSIVE OUTPATIENT PROGRAM CHEMICAL DEPENDENCY ADOLESCENT 906.00 RC facility outpatient 671.00 150.00 157.86 671.00 671.00 per diem 243.00 per diem 243.00 per diem 161.01 per diem 161.01 per diem 671.00 per diem 671.00 per diem 671.00 per diem 250.00 per diem 204.00 per diem 161.01 per diem 174.00 per diem 174.00 per diem 174.00 per diem 243.00 per diem 373.54 per diem 161.01 per diem 200.00 per diem 671.00 per diem 230.00 per diem 230.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 161.01 per diem 671.00 per diem 671.00 per diem 190.00 per diem 224.00 per diem 161.01 per diem 265.00 per diem 325.00 per diem 671.00 per diem 274.00 per diem 161.01 per diem 161.01 per diem 671.00 per diem 275.00 per diem 300.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 671.00 per diem 372.00 per diem 190.00 per diem 157.86 per diem 190.00 per diem 190.00 per diem 190.00 per diem INTENSIVE OUTPATIENT PROGRAM CHEMICAL DEPENDENCY ADULT 906.00 RC facility outpatient 671.00 150.00 157.86 671.00 671.00 per diem 243.00 per diem 243.00 per diem 161.01 per diem 161.01 per diem 671.00 per diem 671.00 per diem 671.00 per diem 250.00 per diem 204.00 per diem 161.01 per diem 174.00 per diem 174.00 per diem 174.00 per diem 243.00 per diem 373.54 per diem 161.01 per diem 200.00 per diem 671.00 per diem 230.00 per diem 230.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 161.01 per diem 671.00 per diem 671.00 per diem 190.00 per diem 224.00 per diem 161.01 per diem 265.00 per diem 325.00 per diem 671.00 per diem 274.00 per diem 161.01 per diem 161.01 per diem 671.00 per diem 275.00 per diem 300.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 671.00 per diem 372.00 per diem 190.00 per diem 157.86 per diem 190.00 per diem 190.00 per diem 190.00 per diem TELE INTENSIVE OUTPATIENT PROGRAM CHEMICAL DEPENDENCY 906.00 RC facility outpatient 671.00 150.00 157.86 671.00 671.00 per diem 243.00 per diem 243.00 per diem 161.01 per diem 161.01 per diem 671.00 per diem 671.00 per diem 671.00 per diem 250.00 per diem 204.00 per diem 161.01 per diem 174.00 per diem 174.00 per diem 174.00 per diem 243.00 per diem 373.54 per diem 161.01 per diem 200.00 per diem 671.00 per diem 230.00 per diem 230.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 161.01 per diem 671.00 per diem 671.00 per diem 190.00 per diem 224.00 per diem 161.01 per diem 265.00 per diem 325.00 per diem 671.00 per diem 274.00 per diem 161.01 per diem 161.01 per diem 671.00 per diem 275.00 per diem 300.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 671.00 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 161.01 per diem 671.00 per diem 372.00 per diem 190.00 per diem 157.86 per diem 190.00 per diem 190.00 per diem 190.00 per diem PARTIAL HOSPITAL PROGRAM CHEMICAL DEPENDENCY 912.00 RC facility outpatient 1118.00 350.00 269.70 1118.00 441.00 per diem 436.00 per diem 1118.00 per diem 269.70 per diem 269.70 per diem 269.70 per diem 379.00 per diem 435.09 per diem 275.00 per diem 1118.00 per diem 457.00 per diem 457.00 per diem 1118.00 per diem 1118.00 per diem 292.00 per diem 446.00 per diem 350.00 per diem 463.00 per diem 1118.00 per diem 383.00 per diem 1118.00 per diem 485.00 per diem 1118.00 per diem 1118.00 per diem 1118.00 per diem 1118.00 per diem 1118.00 per diem 372.00 per diem 292.00 per diem 292.00 per diem 292.00 per diem 292.00 per diem PARTIAL HOSPITAL PROGRAM PSYCH ADOL 912.00 RC facility outpatient 1118.00 350.00 269.70 1118.00 441.00 per diem 436.00 per diem 1118.00 per diem 269.70 per diem 269.70 per diem 269.70 per diem 379.00 per diem 435.09 per diem 275.00 per diem 1118.00 per diem 457.00 per diem 457.00 per diem 1118.00 per diem 1118.00 per diem 292.00 per diem 446.00 per diem 350.00 per diem 463.00 per diem 1118.00 per diem 383.00 per diem 1118.00 per diem 485.00 per diem 1118.00 per diem 1118.00 per diem 1118.00 per diem 1118.00 per diem 1118.00 per diem 372.00 per diem 292.00 per diem 292.00 per diem 292.00 per diem 292.00 per diem INTENSIVE OUTPATIENT PROGRAM CHEMICAL DEPENDENCY PROCESS GRP 1 915.00 RC facility outpatient 224.00 0.00 200.00 372.00 243.00 per diem 232.97 per diem 232.97 per diem 232.97 per diem 200.00 per diem 232.97 per diem 232.97 per diem 232.97 per diem 232.97 per diem 232.97 per diem 224.00 per diem 372.00 per diem 232.97 per diem TELE CHEMICAL DEPENDENCY PROCESS GP 1 915.00 RC facility outpatient 224.00 0.00 224.00 436.00 436.00 per diem 274.61 per diem 274.61 per diem 274.61 per diem 275.00 per diem 274.61 per diem 274.61 per diem 274.61 per diem 274.61 per diem 274.61 per diem 224.00 per diem 372.00 per diem 274.61 per diem PARTIAL HOSPITAL PROGRAM CHEMICAL DEPENDENCY PSYCHED GRP 1 942.00 RC facility outpatient 224.00 0.00 224.00 224.00 224.00 per diem PARTIAL HOSPITAL PROGRAM MH PSYCHED GRP 1 942.00 RC facility outpatient 224.00 0.00 224.00 224.00 224.00 per diem Initial Eval - No Medical 90791.00 RC facility outpatient 260.00 0.00 30.00 194.55 30.00 fee schedule 30.00 fee schedule 163.78 fee schedule 163.78 fee schedule 162.24 fee schedule 163.78 fee schedule 146.68 fee schedule 194.55 fee schedule 160.02 fee schedule 95.16 fee schedule 95.16 fee schedule 159.42 fee schedule 146.68 fee schedule 88.55 fee schedule 88.55 fee schedule 127.12 fee schedule 73.85 fee schedule 160.49 fee schedule 160.49 fee schedule 140.36 fee schedule 142.47 fee schedule 134.01 fee schedule 160.81 fee schedule 135.61 fee schedule 87.43 fee schedule Initial Eval - With Medical 90792.00 RC facility outpatient 310.00 0.00 85.04 219.23 182.69 fee schedule 166.92 fee schedule 219.23 fee schedule 182.69 fee schedule 85.04 fee schedule 85.04 fee schedule 138.00 fee schedule 98.28 fee schedule Est Patient/med Management/low Complex 99213.00 RC facility outpatient 175.00 0.00 64.90 64.90 64.90 fee schedule Initial Hospital Care (30 Min) 99221.00 RC facility outpatient 110.00 0.00 32.23 89.89 72.26 fee schedule 86.71 fee schedule 89.89 fee schedule 57.32 fee schedule 57.32 fee schedule 80.03 fee schedule 32.23 fee schedule 80.97 fee schedule 76.03 fee schedule Initial Hospital Care (50 Min) 99222.00 RC facility outpatient 190.00 0.00 44.32 137.37 118.45 fee schedule 118.45 fee schedule 118.45 fee schedule 125.53 fee schedule 137.37 fee schedule 114.47 fee schedule 44.32 fee schedule 119.26 fee schedule 119.26 fee schedule 95.44 fee schedule Initial Hospital Care (70 Min) 99223.00 RC facility outpatient 260.00 0.00 177.56 177.56 177.56 fee schedule Subseq Care (15 Min) 99231.00 RC facility outpatient 160.00 0.00 22.22 49.49 40.94 fee schedule 40.94 fee schedule 42.43 fee schedule 40.94 fee schedule 47.88 fee schedule 48.86 fee schedule 49.49 fee schedule 42.98 fee schedule 29.35 fee schedule 29.35 fee schedule 40.59 fee schedule 40.78 fee schedule 41.65 fee schedule 47.88 fee schedule 41.36 fee schedule 41.36 fee schedule 41.50 fee schedule 22.22 fee schedule 42.26 fee schedule 35.65 fee schedule 37.57 fee schedule 48.00 fee schedule 42.19 fee schedule 43.16 fee schedule 41.82 fee schedule 44.92 fee schedule 37.74 fee schedule Subseq Care (25 Min) 99232.00 RC facility outpatient 260.00 0.00 15.98 91.76 49.71 fee schedule 49.71 fee schedule 68.93 fee schedule 68.93 fee schedule 68.97 fee schedule 68.93 fee schedule 76.36 fee schedule 82.20 fee schedule 67.74 fee schedule 46.34 fee schedule 46.34 fee schedule 65.22 fee schedule 91.76 fee schedule 82.75 fee schedule 76.36 fee schedule 58.75 fee schedule 58.75 fee schedule 54.07 fee schedule 54.07 fee schedule 70.25 fee schedule 38.17 fee schedule 60.53 fee schedule 65.23 fee schedule 48.00 fee schedule 20.42 fee schedule 59.38 fee schedule 66.97 fee schedule 65.86 fee schedule 39.35 fee schedule 15.98 fee schedule Subseq Care (35 Min) 99233.00 RC facility outpatient 390.00 0.00 48.00 124.00 92.71 fee schedule 92.71 fee schedule 104.79 fee schedule 92.71 fee schedule 124.00 fee schedule 98.75 fee schedule 69.63 fee schedule 69.63 fee schedule 48.15 fee schedule 91.79 fee schedule 48.00 fee schedule 72.00 fee schedule 105.83 fee schedule 109.13 fee schedule 93.63 fee schedule Discharge Day Mgmt <30 Min 99238.00 RC facility outpatient 115.00 0.00 39.05 84.49 69.55 fee schedule 69.55 fee schedule 68.18 fee schedule 69.55 fee schedule 77.88 fee schedule 83.27 fee schedule 69.29 fee schedule 50.10 fee schedule 50.10 fee schedule 69.76 fee schedule 67.44 fee schedule 77.88 fee schedule 41.56 fee schedule 41.56 fee schedule 77.88 fee schedule 39.05 fee schedule 70.46 fee schedule 67.36 fee schedule 40.11 fee schedule 59.61 fee schedule 82.53 fee schedule 69.36 fee schedule 84.49 fee schedule 56.76 fee schedule Initial Eval - No Medical with Modifier 95 9079195.00 RC facility outpatient 260.00 0.00 92.29 185.24 92.29 fee schedule 92.29 fee schedule 185.24 fee schedule 185.24 fee schedule Subseq Care (15 Min) with Modifier 95 9923195.00 RC facility outpatient 310.00 0.00 10.59 45.50 28.39 fee schedule 28.39 fee schedule 43.05 fee schedule 43.18 fee schedule 45.50 fee schedule 10.59 fee schedule