"hospital_HMIH Cedar Crest, LLC" last_updated_ 2023-12-31 version_1 "hospital_Killeen, Texas" hospital_address 2206 East Central Texas Expressway license_ 008216 | TX "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 | 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 MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_AETNA MCR ADVANTAGE | MANAGED MEDICARE] |percent standard_charge|[payer_AETNA MCR ADVANTAGE | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_AMBETTER HEALTH SUPERIOR | HMO/PPO] standard_charge|[payer_AMBETTER HEALTH SUPERIOR | HMO/PPO] |percent standard_charge|[payer_AMBETTER HEALTH SUPERIOR | HMO/PPO] |contracting_method additional_payer_notes |[payer_AMBETTER HEALTH SUPERIOR | HMO/PPO] standard_charge|[payer_AMERIGROUP | MANAGED MEDICAID] standard_charge|[payer_AMERIGROUP | MANAGED MEDICAID] |percent standard_charge|[payer_AMERIGROUP | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AMERIGROUP | MANAGED MEDICAID] standard_charge|[payer_AMERIGROUP MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_AMERIGROUP MCR ADVANTAGE | MANAGED MEDICARE] |percent standard_charge|[payer_AMERIGROUP MCR ADVANTAGE | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AMERIGROUP MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_AMERIGROUP STAR UHRIP | MANAGED MEDICAID] standard_charge|[payer_AMERIGROUP STAR UHRIP | MANAGED MEDICAID] |percent standard_charge|[payer_AMERIGROUP STAR UHRIP | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AMERIGROUP STAR UHRIP | MANAGED MEDICAID] standard_charge|[payer_AZ BANNER | MEDICAID: CBS OOS] standard_charge|[payer_AZ BANNER | MEDICAID: CBS OOS] |percent standard_charge|[payer_AZ BANNER | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_AZ BANNER | MEDICAID: CBS OOS] standard_charge|[payer_AZ COMPLETE HEALTH | MEDICAID: CBS OOS] standard_charge|[payer_AZ COMPLETE HEALTH | MEDICAID: CBS OOS] |percent standard_charge|[payer_AZ COMPLETE HEALTH | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_AZ COMPLETE HEALTH | MEDICAID: CBS OOS] standard_charge|[payer_AZ DCS | LOCAL GOVT] standard_charge|[payer_AZ DCS | LOCAL GOVT] |percent standard_charge|[payer_AZ DCS | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AZ DCS | LOCAL GOVT] standard_charge|[payer_AZ MERCY CARE | MEDICAID: CBS OOS] standard_charge|[payer_AZ MERCY CARE | MEDICAID: CBS OOS] |percent standard_charge|[payer_AZ MERCY CARE | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_AZ MERCY CARE | MEDICAID: CBS OOS] standard_charge|[payer_AZ OPTUM | MEDICAID: CBS OOS] standard_charge|[payer_AZ OPTUM | MEDICAID: CBS OOS] |percent standard_charge|[payer_AZ OPTUM | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_AZ OPTUM | MEDICAID: CBS OOS] standard_charge|[payer_BCBS ADVANTAGE HMO | BLUE CROSS] standard_charge|[payer_BCBS ADVANTAGE HMO | BLUE CROSS] |percent standard_charge|[payer_BCBS ADVANTAGE HMO | BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS ADVANTAGE HMO | BLUE CROSS] standard_charge|[payer_BCBS HMO | BLUE CROSS] standard_charge|[payer_BCBS HMO | BLUE CROSS] |percent standard_charge|[payer_BCBS HMO | BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS HMO | BLUE CROSS] standard_charge|[payer_BCBS MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_BCBS MCR ADVANTAGE | MANAGED MEDICARE] |percent standard_charge|[payer_BCBS MCR ADVANTAGE | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BCBS MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_BCBS TEXAS HEALTH SELECT | BLUE CROSS] standard_charge|[payer_BCBS TEXAS HEALTH SELECT | BLUE CROSS] |percent standard_charge|[payer_BCBS TEXAS HEALTH SELECT | BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS TEXAS HEALTH SELECT | BLUE CROSS] standard_charge|[payer_BCBS TEXAS PPO POS FED | BLUE CROSS] standard_charge|[payer_BCBS TEXAS PPO POS FED | BLUE CROSS] |percent standard_charge|[payer_BCBS TEXAS PPO POS FED | BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS TEXAS PPO POS FED | BLUE CROSS] standard_charge|[payer_BEACON CHILDRENS MED CTR | MANAGED MEDICAID] standard_charge|[payer_BEACON CHILDRENS MED CTR | MANAGED MEDICAID] |percent standard_charge|[payer_BEACON CHILDRENS MED CTR | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BEACON CHILDRENS MED CTR | MANAGED MEDICAID] standard_charge|[payer_BEACON COMMUNITY HEALTH | MANAGED MEDICAID] standard_charge|[payer_BEACON COMMUNITY HEALTH | MANAGED MEDICAID] |percent standard_charge|[payer_BEACON COMMUNITY HEALTH | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BEACON COMMUNITY HEALTH | MANAGED MEDICAID] standard_charge|[payer_BEACON COOK CHILDRENS| MANAGED MEDICAID] standard_charge|[payer_BEACON COOK CHILDRENS| MANAGED MEDICAID] |percent standard_charge|[payer_BEACON COOK CHILDRENS| MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BEACON COOK CHILDRENS| MANAGED MEDICAID] 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_BEACON NORTH STAR MCD | MANAGED MEDICAID] standard_charge|[payer_BEACON NORTH STAR MCD | MANAGED MEDICAID] |percent standard_charge|[payer_BEACON NORTH STAR MCD | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BEACON NORTH STAR MCD | MANAGED MEDICAID] standard_charge|[payer_BEACON SENDERO HEALTH | MANAGED MEDICAID] standard_charge|[payer_BEACON SENDERO HEALTH | MANAGED MEDICAID] |percent standard_charge|[payer_BEACON SENDERO HEALTH | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BEACON SENDERO HEALTH | MANAGED MEDICAID] standard_charge|[payer_BELL COUNTY IHCP | LOCAL GOVT] standard_charge|[payer_BELL COUNTY IHCP | LOCAL GOVT] |percent standard_charge|[payer_BELL COUNTY IHCP | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_BELL COUNTY IHCP | LOCAL GOVT] standard_charge|[payer_BELL LAMPASAS CO CSCD | LOCAL GOVT] standard_charge|[payer_BELL LAMPASAS CO CSCD | LOCAL GOVT] |percent standard_charge|[payer_BELL LAMPASAS CO CSCD | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_BELL LAMPASAS CO CSCD | LOCAL GOVT] standard_charge|[payer_BLUEBONNET TRAILS | LOCAL GOVT] standard_charge|[payer_BLUEBONNET TRAILS | LOCAL GOVT] |percent standard_charge|[payer_BLUEBONNET TRAILS | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_BLUEBONNET TRAILS | LOCAL GOVT] standard_charge|[payer_CARELON BEHAVIORAL HEALTH | MANAGED MEDICAID] standard_charge|[payer_CARELON BEHAVIORAL HEALTH | MANAGED MEDICAID] |percent standard_charge|[payer_CARELON BEHAVIORAL HEALTH | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_CARELON BEHAVIORAL HEALTH | MANAGED MEDICAID] 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_CO ACCESS | MEDICAID: OUT OF STATE] standard_charge|[payer_CO ACCESS | MEDICAID: OUT OF STATE] |percent standard_charge|[payer_CO ACCESS | MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_CO ACCESS | MEDICAID: OUT OF STATE] standard_charge|[payer_CO BEACON | MEDICAID: CBS OOS] standard_charge|[payer_CO BEACON | MEDICAID: CBS OOS] |percent standard_charge|[payer_CO BEACON | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CO BEACON | MEDICAID: CBS OOS] standard_charge|[payer_CO CCHA | MEDICAID: CBS OOS] standard_charge|[payer_CO CCHA | MEDICAID: CBS OOS] |percent standard_charge|[payer_CO CCHA | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CO CCHA | MEDICAID: CBS OOS] standard_charge|[payer_CO EL PASO COUNTY | LOCAL GOVT] standard_charge|[payer_CO EL PASO COUNTY | LOCAL GOVT] |percent standard_charge|[payer_CO EL PASO COUNTY | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_CO EL PASO COUNTY | LOCAL GOVT] 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_CO HEALTH FIRST MCD |MEDICAID: CBS OOS] standard_charge|[payer_CO HEALTH FIRST MCD |MEDICAID: CBS OOS] |percent standard_charge|[payer_CO HEALTH FIRST MCD |MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CO HEALTH FIRST MCD |MEDICAID: CBS OOS] standard_charge|[payer_CO WELD COUNTY MCD | MEDICAID: OUT OF STATE] standard_charge|[payer_CO WELD COUNTY MCD | MEDICAID: OUT OF STATE] |percent standard_charge|[payer_CO WELD COUNTY MCD | MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_CO WELD COUNTY MCD | MEDICAID: OUT OF STATE] standard_charge|[payer_COMMUN HLTH MARKETPLACE | HMO/PPO] standard_charge|[payer_COMMUN HLTH MARKETPLACE | HMO/PPO] |percent standard_charge|[payer_COMMUN HLTH MARKETPLACE | HMO/PPO] |contracting_method additional_payer_notes |[payer_COMMUN HLTH MARKETPLACE | HMO/PPO] standard_charge|[payer_COMMUN HLTH MCD | MANAGED MEDICAID] standard_charge|[payer_COMMUN HLTH MCD | MANAGED MEDICAID] |percent standard_charge|[payer_COMMUN HLTH MCD | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_COMMUN HLTH MCD | MANAGED MEDICAID] standard_charge|[payer_COMMUN HLTH MCR | MANAGED MEDICARE] standard_charge|[payer_COMMUN HLTH MCR | MANAGED MEDICARE] |percent standard_charge|[payer_COMMUN HLTH MCR | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_COMMUN HLTH MCR | MANAGED MEDICARE] standard_charge|[payer_COMPREHENSIVE BEH CARE | LOCAL GOVT] standard_charge|[payer_COMPREHENSIVE BEH CARE | LOCAL GOVT] |percent standard_charge|[payer_COMPREHENSIVE BEH CARE | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_COMPREHENSIVE BEH CARE | LOCAL GOVT] standard_charge|[payer_COMPSYCH | HMO/PPO] standard_charge|[payer_COMPSYCH | HMO/PPO] |percent standard_charge|[payer_COMPSYCH | HMO/PPO] |contracting_method additional_payer_notes |[payer_COMPSYCH | HMO/PPO] standard_charge|[payer_DFPS | LOCAL GOVT] standard_charge|[payer_DFPS | LOCAL GOVT] |percent standard_charge|[payer_DFPS | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_DFPS | LOCAL GOVT] standard_charge|[payer_DRISCOLL HEALTH PLAN | MANAGED MEDICAID] standard_charge|[payer_DRISCOLL HEALTH PLAN | MANAGED MEDICAID] |percent standard_charge|[payer_DRISCOLL HEALTH PLAN | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_DRISCOLL HEALTH PLAN | MANAGED MEDICAID] standard_charge|[payer_EVERNORTH HEALTH | HMO/PPO] standard_charge|[payer_EVERNORTH HEALTH | HMO/PPO] |percent standard_charge|[payer_EVERNORTH HEALTH | HMO/PPO] |contracting_method additional_payer_notes |[payer_EVERNORTH HEALTH | HMO/PPO] standard_charge|[payer_EVERNORTH MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_EVERNORTH MCR ADVANTAGE | MANAGED MEDICARE] |percent standard_charge|[payer_EVERNORTH MCR ADVANTAGE | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_EVERNORTH MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_FIRST HEALTH NETWORK | HMO/PPO] standard_charge|[payer_FIRST HEALTH NETWORK | HMO/PPO] |percent standard_charge|[payer_FIRST HEALTH NETWORK | HMO/PPO] |contracting_method additional_payer_notes |[payer_FIRST HEALTH NETWORK | HMO/PPO] standard_charge|[payer_FIRSTCARE HEALTH PLANS | HMO/PPO] standard_charge|[payer_FIRSTCARE HEALTH PLANS | HMO/PPO] |percent standard_charge|[payer_FIRSTCARE HEALTH PLANS | HMO/PPO] |contracting_method additional_payer_notes |[payer_FIRSTCARE HEALTH PLANS | HMO/PPO] standard_charge|[payer_FIRSTCARE MCD STAR/CHIP | MANAGED MEDICAID] standard_charge|[payer_FIRSTCARE MCD STAR/CHIP | MANAGED MEDICAID] |percent standard_charge|[payer_FIRSTCARE MCD STAR/CHIP | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_FIRSTCARE MCD STAR/CHIP | MANAGED MEDICAID] standard_charge|[payer_FIRSTCARE MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_FIRSTCARE MCR ADVANTAGE | MANAGED MEDICARE] |percent standard_charge|[payer_FIRSTCARE MCR ADVANTAGE | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_FIRSTCARE MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_GEHA | COMMERCIAL] standard_charge|[payer_GEHA | COMMERCIAL] |percent standard_charge|[payer_GEHA | COMMERCIAL] |contracting_method additional_payer_notes |[payer_GEHA | COMMERCIAL] standard_charge|[payer_HEALTH SMART | HMO/PPO] standard_charge|[payer_HEALTH SMART | HMO/PPO] |percent standard_charge|[payer_HEALTH SMART | HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTH SMART | HMO/PPO] standard_charge|[payer_HI DEPT OF HEALTH | LOCAL GOVT] standard_charge|[payer_HI DEPT OF HEALTH | LOCAL GOVT] |percent standard_charge|[payer_HI DEPT OF HEALTH | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_HI DEPT OF HEALTH | LOCAL GOVT] standard_charge|[payer_HUMANA BEHAVIORAL HEALTH | HMO/PPO] standard_charge|[payer_HUMANA BEHAVIORAL HEALTH | HMO/PPO] |percent standard_charge|[payer_HUMANA BEHAVIORAL HEALTH | HMO/PPO] |contracting_method additional_payer_notes |[payer_HUMANA BEHAVIORAL HEALTH | HMO/PPO] standard_charge|[payer_HUMANA MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_HUMANA MCR ADVANTAGE | MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA MCR ADVANTAGE | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA MCR ADVANTAGE | MANAGED MEDICARE] standard_charge|[payer_ICE HEALTH SERVICE CORPS | LOCAL GOVT] standard_charge|[payer_ICE HEALTH SERVICE CORPS | LOCAL GOVT] |percent standard_charge|[payer_ICE HEALTH SERVICE CORPS | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ICE HEALTH SERVICE CORPS | LOCAL GOVT] standard_charge|[payer_ID DHW | LOCAL GOVT] standard_charge|[payer_ID DHW | LOCAL GOVT] |percent standard_charge|[payer_ID DHW | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ID DHW | LOCAL GOVT] standard_charge|[payer_INTEGRATED BEHAVIORAL HEA | HMO/PPO] standard_charge|[payer_INTEGRATED BEHAVIORAL HEA | HMO/PPO] |percent standard_charge|[payer_INTEGRATED BEHAVIORAL HEA | HMO/PPO] |contracting_method additional_payer_notes |[payer_INTEGRATED BEHAVIORAL HEA | HMO/PPO] standard_charge|[payer_MAGELLAN BCBS MCD | MANAGED MEDICAID] standard_charge|[payer_MAGELLAN BCBS MCD | MANAGED MEDICAID] |percent standard_charge|[payer_MAGELLAN BCBS MCD | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MAGELLAN BCBS MCD | MANAGED MEDICAID] standard_charge|[payer_MAGELLAN HMO/PPO | HMO/PPO] standard_charge|[payer_MAGELLAN HMO/PPO | HMO/PPO] |percent standard_charge|[payer_MAGELLAN HMO/PPO | HMO/PPO] |contracting_method additional_payer_notes |[payer_MAGELLAN HMO/PPO | HMO/PPO] standard_charge|[payer_MAGELLAN STAR CHIP MCD | MANAGED MEDICAID] standard_charge|[payer_MAGELLAN STAR CHIP MCD | MANAGED MEDICAID] |percent standard_charge|[payer_MAGELLAN STAR CHIP MCD | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MAGELLAN STAR CHIP MCD | MANAGED MEDICAID] standard_charge|[payer_MANAGED HEALTH NETWORK | HMO/PPO] standard_charge|[payer_MANAGED HEALTH NETWORK | HMO/PPO] |percent standard_charge|[payer_MANAGED HEALTH NETWORK | HMO/PPO] |contracting_method additional_payer_notes |[payer_MANAGED HEALTH NETWORK | HMO/PPO] standard_charge|[payer_MEDICAID | MEDICAID ] standard_charge|[payer_MEDICAID | MEDICAID ] |percent standard_charge|[payer_MEDICAID | MEDICAID ] |contracting_method additional_payer_notes |[payer_MEDICAID | MEDICAID ] standard_charge|[payer_MEDICAID OUT OF STATE | MEDICAID: CBS OOS] standard_charge|[payer_MEDICAID OUT OF STATE | MEDICAID: CBS OOS] |percent standard_charge|[payer_MEDICAID OUT OF STATE | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MEDICAID OUT OF STATE | MEDICAID: CBS OOS] 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 ARIZONA MCD | MEDICAID: OUT OF STATE] standard_charge|[payer_MERCY CARE ARIZONA MCD | MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MERCY CARE ARIZONA MCD | MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MERCY CARE ARIZONA MCD | MEDICAID: OUT OF STATE] standard_charge|[payer_MERCY CARE RBHA | MEDICAID: OUT OF STATE] standard_charge|[payer_MERCY CARE RBHA | MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MERCY CARE RBHA | MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MERCY CARE RBHA | MEDICAID: OUT OF STATE] standard_charge|[payer_MGD MEDICAID OUT OF STATE | MEDICAID: CBS OOS] standard_charge|[payer_MGD MEDICAID OUT OF STATE | MEDICAID: CBS OOS] |percent standard_charge|[payer_MGD MEDICAID OUT OF STATE | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MGD MEDICAID OUT OF STATE | MEDICAID: CBS OOS] standard_charge|[payer_MHMR BRAZOS VALLEY | LOCAL GOVT] standard_charge|[payer_MHMR BRAZOS VALLEY | LOCAL GOVT] |percent standard_charge|[payer_MHMR BRAZOS VALLEY | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MHMR BRAZOS VALLEY | LOCAL GOVT] standard_charge|[payer_MHMR BROWNWOOD | LOCAL GOVT] standard_charge|[payer_MHMR BROWNWOOD | LOCAL GOVT] |percent standard_charge|[payer_MHMR BROWNWOOD | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MHMR BROWNWOOD | LOCAL GOVT] standard_charge|[payer_MHMR CENTRAL COUNTIES | LOCAL GOVT] standard_charge|[payer_MHMR CENTRAL COUNTIES | LOCAL GOVT] |percent standard_charge|[payer_MHMR CENTRAL COUNTIES | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MHMR CENTRAL COUNTIES | LOCAL GOVT] standard_charge|[payer_MHMR HEART OF TEXAS | LOCAL GOVT] standard_charge|[payer_MHMR HEART OF TEXAS | LOCAL GOVT] |percent standard_charge|[payer_MHMR HEART OF TEXAS | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MHMR HEART OF TEXAS | LOCAL GOVT] standard_charge|[payer_MHMR MISC | LOCAL GOVT] standard_charge|[payer_MHMR MISC | LOCAL GOVT] |percent standard_charge|[payer_MHMR MISC | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MHMR MISC | LOCAL GOVT] standard_charge|[payer_MHNET MENTAL HEALTH NETWK | HMO/PPO] standard_charge|[payer_MHNET MENTAL HEALTH NETWK | HMO/PPO] |percent standard_charge|[payer_MHNET MENTAL HEALTH NETWK | HMO/PPO] |contracting_method additional_payer_notes |[payer_MHNET MENTAL HEALTH NETWK | HMO/PPO] standard_charge|[payer_MISC COMMERCIAL ACUTE | COMMERCIAL] standard_charge|[payer_MISC COMMERCIAL ACUTE | COMMERCIAL] |percent standard_charge|[payer_MISC COMMERCIAL ACUTE | COMMERCIAL] |contracting_method additional_payer_notes |[payer_MISC COMMERCIAL ACUTE | COMMERCIAL] standard_charge|[payer_MISC MGD MCD | MANAGED MEDICAID] standard_charge|[payer_MISC MGD MCD | MANAGED MEDICAID] |percent standard_charge|[payer_MISC MGD MCD | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MISC MGD MCD | MANAGED MEDICAID] standard_charge|[payer_MISC MGD MCR | MANAGED MEDICARE] standard_charge|[payer_MISC MGD MCR | MANAGED MEDICARE] |percent standard_charge|[payer_MISC MGD MCR | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MISC MGD MCR | MANAGED MEDICARE] standard_charge|[payer_MO DSS | LOCAL GOVT] standard_charge|[payer_MO DSS | LOCAL GOVT] |percent standard_charge|[payer_MO DSS | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MO DSS | LOCAL GOVT] standard_charge|[payer_MOLINA HEALTHCARE | MANAGED MEDICAID] standard_charge|[payer_MOLINA HEALTHCARE | MANAGED MEDICAID] |percent standard_charge|[payer_MOLINA HEALTHCARE | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MOLINA HEALTHCARE | MANAGED MEDICAID] standard_charge|[payer_MUTUAL OF OMAHA | HMO/PPO] standard_charge|[payer_MUTUAL OF OMAHA | HMO/PPO] |percent standard_charge|[payer_MUTUAL OF OMAHA | HMO/PPO] |contracting_method additional_payer_notes |[payer_MUTUAL OF OMAHA | HMO/PPO] standard_charge|[payer_OH CUYAHOGA COUNTY | LOCAL GOVT] standard_charge|[payer_OH CUYAHOGA COUNTY | LOCAL GOVT] |percent standard_charge|[payer_OH CUYAHOGA COUNTY | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OH CUYAHOGA COUNTY | LOCAL GOVT] standard_charge|[payer_OPTUM MEDICAID WASHINGTON | MEDICAID: OUT OF STATE] standard_charge|[payer_OPTUM MEDICAID WASHINGTON | MEDICAID: OUT OF STATE] |percent standard_charge|[payer_OPTUM MEDICAID WASHINGTON | MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_OPTUM MEDICAID WASHINGTON | MEDICAID: OUT OF STATE] standard_charge|[payer_OPTUM UBH COMMUN MCD CHIP | MANAGED MEDICAID] standard_charge|[payer_OPTUM UBH COMMUN MCD CHIP | MANAGED MEDICAID] |percent standard_charge|[payer_OPTUM UBH COMMUN MCD CHIP | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_OPTUM UBH COMMUN MCD CHIP | MANAGED MEDICAID] standard_charge|[payer_OPTUM UBH STAR UHRIP | MANAGED MEDICAID] standard_charge|[payer_OPTUM UBH STAR UHRIP | MANAGED MEDICAID] |percent standard_charge|[payer_OPTUM UBH STAR UHRIP | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_OPTUM UBH STAR UHRIP | MANAGED MEDICAID] standard_charge|[payer_OPTUM UBH STAR+PLUS UHRIP | MANAGED MEDICAID] standard_charge|[payer_OPTUM UBH STAR+PLUS UHRIP | MANAGED MEDICAID] |percent standard_charge|[payer_OPTUM UBH STAR+PLUS UHRIP | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_OPTUM UBH STAR+PLUS UHRIP | MANAGED MEDICAID] standard_charge|[payer_OPTUM-MCR CARE IMPR PLUS | MANAGED MEDICARE] standard_charge|[payer_OPTUM-MCR CARE IMPR PLUS | MANAGED MEDICARE] |percent standard_charge|[payer_OPTUM-MCR CARE IMPR PLUS | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_OPTUM-MCR CARE IMPR PLUS | MANAGED MEDICARE] standard_charge|[payer_OPTUM-UHC STAR+PLUS MCD | MANAGED MEDICAID] standard_charge|[payer_OPTUM-UHC STAR+PLUS MCD | MANAGED MEDICAID] |percent standard_charge|[payer_OPTUM-UHC STAR+PLUS MCD | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_OPTUM-UHC STAR+PLUS MCD | MANAGED MEDICAID] standard_charge|[payer_PHCS/MULTIPLAN | HMO/PPO] standard_charge|[payer_PHCS/MULTIPLAN | HMO/PPO] |percent standard_charge|[payer_PHCS/MULTIPLAN | HMO/PPO] |contracting_method additional_payer_notes |[payer_PHCS/MULTIPLAN | HMO/PPO] standard_charge|[payer_RAMSEY COUNTY DFPS | LOCAL GOVT] standard_charge|[payer_RAMSEY COUNTY DFPS | LOCAL GOVT] |percent standard_charge|[payer_RAMSEY COUNTY DFPS | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_RAMSEY COUNTY DFPS | LOCAL GOVT] standard_charge|[payer_SCOTT WHITE HEALTH PLAN | HMO/PPO] standard_charge|[payer_SCOTT WHITE HEALTH PLAN | HMO/PPO] |percent standard_charge|[payer_SCOTT WHITE HEALTH PLAN | HMO/PPO] |contracting_method additional_payer_notes |[payer_SCOTT WHITE HEALTH PLAN | HMO/PPO] standard_charge|[payer_SETON CHIP DELL CHILDRENS | MANAGED MEDICAID] standard_charge|[payer_SETON CHIP DELL CHILDRENS | MANAGED MEDICAID] |percent standard_charge|[payer_SETON CHIP DELL CHILDRENS | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SETON CHIP DELL CHILDRENS | MANAGED MEDICAID] standard_charge|[payer_SETON HEALTH PLAN | HMO/PPO] standard_charge|[payer_SETON HEALTH PLAN | HMO/PPO] |percent standard_charge|[payer_SETON HEALTH PLAN | HMO/PPO] |contracting_method additional_payer_notes |[payer_SETON HEALTH PLAN | HMO/PPO] standard_charge|[payer_SETON STAR DELL CHILDRENS | MANAGED MEDICAID] standard_charge|[payer_SETON STAR DELL CHILDRENS | MANAGED MEDICAID] |percent standard_charge|[payer_SETON STAR DELL CHILDRENS | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SETON STAR DELL CHILDRENS | MANAGED MEDICAID] standard_charge|[payer_SMART HEALTH ASCENSION | BLUE CROSS] standard_charge|[payer_SMART HEALTH ASCENSION | BLUE CROSS] |percent standard_charge|[payer_SMART HEALTH ASCENSION | BLUE CROSS] |contracting_method additional_payer_notes |[payer_SMART HEALTH ASCENSION | BLUE CROSS] standard_charge|[payer_STEWARD HEALTH CHOICE | MEDICAID: OUT OF STATE] standard_charge|[payer_STEWARD HEALTH CHOICE | MEDICAID: OUT OF STATE] |percent standard_charge|[payer_STEWARD HEALTH CHOICE | MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_STEWARD HEALTH CHOICE | MEDICAID: OUT OF STATE] standard_charge|[payer_SUPERIOR FOSTER | MANAGED MEDICAID] standard_charge|[payer_SUPERIOR FOSTER | MANAGED MEDICAID] |percent standard_charge|[payer_SUPERIOR FOSTER | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SUPERIOR FOSTER | MANAGED MEDICAID] standard_charge|[payer_SUPERIOR HEALTH PLAN | MANAGED MEDICAID] standard_charge|[payer_SUPERIOR HEALTH PLAN | MANAGED MEDICAID] |percent standard_charge|[payer_SUPERIOR HEALTH PLAN | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SUPERIOR HEALTH PLAN | MANAGED MEDICAID] standard_charge|[payer_SUPERIOR STAR UHRIP | MANAGED MEDICAID] standard_charge|[payer_SUPERIOR STAR UHRIP | MANAGED MEDICAID] |percent standard_charge|[payer_SUPERIOR STAR UHRIP | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SUPERIOR STAR UHRIP | MANAGED MEDICAID] standard_charge|[payer_SW RIGHTCARE STAR UHRIP | MANAGED MEDICAID] standard_charge|[payer_SW RIGHTCARE STAR UHRIP | MANAGED MEDICAID] |percent standard_charge|[payer_SW RIGHTCARE STAR UHRIP | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SW RIGHTCARE STAR UHRIP | MANAGED MEDICAID] standard_charge|[payer_SW RIGHTCARE/VALENCE | MANAGED MEDICAID] standard_charge|[payer_SW RIGHTCARE/VALENCE | MANAGED MEDICAID] |percent standard_charge|[payer_SW RIGHTCARE/VALENCE | MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SW RIGHTCARE/VALENCE | MANAGED MEDICAID] standard_charge|[payer_SWHP SENIOR CARE | MANAGED MEDICARE] standard_charge|[payer_SWHP SENIOR CARE | MANAGED MEDICARE] |percent standard_charge|[payer_SWHP SENIOR CARE | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_SWHP SENIOR CARE | MANAGED MEDICARE] standard_charge|[payer_TRI WEST REGION CLAIMS | TRICARE] standard_charge|[payer_TRI WEST REGION CLAIMS | TRICARE] |percent standard_charge|[payer_TRI WEST REGION CLAIMS | TRICARE] |contracting_method additional_payer_notes |[payer_TRI WEST REGION CLAIMS | TRICARE] standard_charge|[payer_TRICARE EAST REGION | TRICARE] standard_charge|[payer_TRICARE EAST REGION | TRICARE] |percent standard_charge|[payer_TRICARE EAST REGION | TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE EAST REGION | 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 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_TX BELONG TO BELONG | LOCAL GOVT] standard_charge|[payer_TX BELONG TO BELONG | LOCAL GOVT] |percent standard_charge|[payer_TX BELONG TO BELONG | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TX BELONG TO BELONG | LOCAL GOVT] standard_charge|[payer_TX DFPS | LOCAL GOVT] standard_charge|[payer_TX DFPS | LOCAL GOVT] |percent standard_charge|[payer_TX DFPS | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TX DFPS | LOCAL GOVT] standard_charge|[payer_TX OCOK | LOCAL GOVT] standard_charge|[payer_TX OCOK | LOCAL GOVT] |percent standard_charge|[payer_TX OCOK | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TX OCOK | LOCAL GOVT] standard_charge|[payer_UBH MCR ADVANTAGE| MANAGED MEDICARE] standard_charge|[payer_UBH MCR ADVANTAGE| MANAGED MEDICARE] |percent standard_charge|[payer_UBH MCR ADVANTAGE| MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UBH MCR ADVANTAGE| MANAGED MEDICARE] standard_charge|[payer_UBH/MCR CARE IMPROV PLUS | MANAGED MEDICARE] standard_charge|[payer_UBH/MCR CARE IMPROV PLUS | MANAGED MEDICARE] |percent standard_charge|[payer_UBH/MCR CARE IMPROV PLUS | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UBH/MCR CARE IMPROV PLUS | MANAGED MEDICARE] 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 HEALTH CARE | HMO/PPO] standard_charge|[payer_UNITED HEALTH CARE | HMO/PPO] |percent standard_charge|[payer_UNITED HEALTH CARE | HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED HEALTH CARE | HMO/PPO] standard_charge|[payer_USA MANAGED CARE| HMO/PPO] standard_charge|[payer_USA MANAGED CARE| HMO/PPO] |percent standard_charge|[payer_USA MANAGED CARE| HMO/PPO] |contracting_method additional_payer_notes |[payer_USA MANAGED CARE| HMO/PPO] standard_charge|[payer_VA STAFFORD COUNTY | LOCAL GOVT] standard_charge|[payer_VA STAFFORD COUNTY | LOCAL GOVT] |percent standard_charge|[payer_VA STAFFORD COUNTY | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_VA STAFFORD COUNTY | LOCAL GOVT] standard_charge|[payer_VAPC3 | TRICARE] standard_charge|[payer_VAPC3 | TRICARE] |percent standard_charge|[payer_VAPC3 | TRICARE] |contracting_method additional_payer_notes |[payer_VAPC3 | TRICARE] standard_charge|[payer_VAPC3 | VETERANS ADMIN] standard_charge|[payer_VAPC3 | VETERANS ADMIN] |percent standard_charge|[payer_VAPC3 | VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_VAPC3 | VETERANS ADMIN] standard_charge|[payer_WA COORDINATED CARE | MEDICAID: CBS OOS] standard_charge|[payer_WA COORDINATED CARE | MEDICAID: CBS OOS] |percent standard_charge|[payer_WA COORDINATED CARE | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_WA COORDINATED CARE | MEDICAID: CBS OOS] standard_charge|[payer_WA MOLINA | MEDICAID: CBS OOS] standard_charge|[payer_WA MOLINA | MEDICAID: CBS OOS] |percent standard_charge|[payer_WA MOLINA | MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_WA MOLINA | MEDICAID: CBS OOS] standard_charge|[payer_WESTERN SKY COMMUNITY CAR | MEDICAID: OUT OF STATE] standard_charge|[payer_WESTERN SKY COMMUNITY CAR | MEDICAID: OUT OF STATE] |percent standard_charge|[payer_WESTERN SKY COMMUNITY CAR | MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_WESTERN SKY COMMUNITY CAR | MEDICAID: OUT OF STATE] standard_charge|[payer_WILLIAMSON COUNTY JUVENIL | LOCAL GOVT] standard_charge|[payer_WILLIAMSON COUNTY JUVENIL | LOCAL GOVT] |percent standard_charge|[payer_WILLIAMSON COUNTY JUVENIL | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WILLIAMSON COUNTY JUVENIL | LOCAL GOVT] standard_charge|[payer_WINNEBAGO COUNTY | LOCAL GOVT] standard_charge|[payer_WINNEBAGO COUNTY | LOCAL GOVT] |percent standard_charge|[payer_WINNEBAGO COUNTY | LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WINNEBAGO COUNTY | LOCAL GOVT] ACUTE ADULT INPT 124 RC facility inpatient 2500.00 700 492.66 1500 908 803 700 550 842.3 814 595 753 842.3 753 805 529.59 529.59 529.59 731 600 492.66 600 625 529.59 842.3 650 650 842.3 740 760 794.39 859 810 815 550 529.59 842.3 600 495 860 842.3 842.3 645 842 842 842 529.59 525 842.3 525 600 600 675 625 600 628 1500 529.59 842.3 650 600 529.59 783.8 783.8 842.3 529.59 650 700 550 600 550 600 500 668 668 988.64 783.8 529.59 880.71 928.06 880.71 823.98 794 842.3 842.3 840 665 842.3 1062.6 ACUTE CHILD & ADOL 124 RC facility inpatient 2500.00 700 492.66 1500 908 803 700 550 814 595 753 753 805 529.59 529.59 529.59 731 600 492.66 600 625 529.59 842.3 650 650 842.3 740 760 794.39 859 810 815 550 529.59 842.3 600 495 860 842.3 842.3 645 842 842 842 529.59 525 842.3 525 600 600 675 625 600 628 1500 529.59 842.3 650 600 529.59 783.8 783.8 842.3 529.59 650 700 550 600 550 600 500 668 668 988.64 783.8 529.59 880.71 928.06 880.71 823.98 794 842.3 842.3 840 665 842.3 1062.6 ACUTE AD&GERO CD DET 126 RC facility inpatient 2500.00 492.66 1500 908 803 700 550 814 595 753 753 805 529.59 529.59 529.59 731 600 492.66 600 625 529.59 650 650 842.3 794.39 859 810 815 550 529.59 842.3 600 495 860 842.3 842.3 600 842 842 842 529.59 842.3 1500 529.59 783.8 783.8 842.3 529.59 650 700 550 600 550 600 668 668 988.64 783.8 529.59 880.71 928.06 880.71 823.98 794 842.3 842.3 840 665 842.3 ACUTE ADOL CD DETOX 126 RC facility inpatient 2500.00 492.66 1500 908 803 700 550 595 753 753 805 529.59 529.59 529.59 731 600 492.66 600 625 529.59 650 650 842.3 794.39 859 810 815 550 529.59 842.3 600 495 860 842.3 842.3 600 842 842 842 529.59 842.3 1500 529.59 783.8 783.8 842.3 529.59 650 700 550 600 550 600 668 668 988.64 783.8 529.59 880.71 928.06 880.71 823.98 794 842.3 842.3 840 665 842.3 ACUTE ADOL CD REHAB 128 RC facility inpatient 2500.00 400 1500 908 803 680 550 529.59 529.59 529.59 731 600 492.66 600 625 650 650 842.3 740 794.39 859 810 815 400 529.59 842.3 600 495 610 842.3 842.3 600 842 842 842 529.59 842.3 628 1500 490 700 880.71 928.06 880.71 842.3 BRIDGE ON DC AME ADO 513 RC facility inpatient 80.00 102.86 121 121.3 102.86 BRIDGE ON DC TRI ADO 513 RC facility inpatient 121.30 102.86 121 121.3 102.86 INTENSIVE OP ADOLESC 905 RC facility outpatient 625.00 225 125 2000 211 187 150 170 228 228 240 150 150 156 150 2000 150 150 150 194.1 275 190 189 125 170 194.1 231 231 231 137 194.1 139 150 145 145 150 150 150 140 150 150 175.71 175.71 145 145 153 INTENSIVE OUTPATIENT PROGRAM MH ADULT 905 RC facility outpatient 625.00 225 125 2000 211 187 150 170 228 228 240 150 150 156 150 2000 150 150 150 194.1 275 190 189 125 170 194.1 231 231 231 137 194.1 139 150 145 145 150 150 150 140 150 150 175.71 175.71 145 145 153 TELE INTENSIVE OUTPATIENT PROGRAM ADOL PSYCH 905 RC facility outpatient 625.00 225 125 2000 211 187 150 170 228 228 240 150 150 156 150 2000 150 150 150 194.1 275 190 189 125 170 194.1 231 231 231 137 194.1 139 150 145 145 150 150 150 140 150 150 175.71 175.71 145 145 153 TELE INTENSIVE OUTPATIENT PROGRAM ADULT MH 905 RC facility outpatient 625.00 225 125 2000 211 187 150 170 228 228 240 150 150 156 150 2000 150 150 150 194.1 275 190 189 125 170 194.1 231 231 231 137 194.1 139 150 145 145 150 150 150 140 150 150 175.71 175.71 145 145 153 INTENSIVE OP CD ADUL 906 RC facility outpatient 625.00 225 125 2000 211 187 150 170 228 228 281 150 150 156 150 2000 150 150 150 194.1 275 190 189 125 170 194.1 231 231 231 137 194.1 139 150 145 145 150 150 150 140 150 150 145 145 153 PARTIAL HOSPITAL PROGRAM HALF DAY ADOL 912 RC facility outpatient 625.00 225 135 454 454 150 212 267 267 450 275 275 286 275 275 225 225 216.79 340 189 225 355 194.1 225 356 356 356 252 216.19 309 175 165 275 275 135 275 250 267 275 194.1 246.56 257.29 200.06 200.06 145 153 246.56 PARTIAL HOSPITAL PROGRAM HALF MH ADULT 912 RC facility outpatient 825.00 225 135 454 454 150 212 267 267 450 275 275 286 275 275 225 225 216.79 340 189 225 355 194.1 225 356 356 356 252 216.19 309 175 165 275 275 135 275 250 267 275 194.1 246.56 257.29 200.06 200.06 145 153 246.56 PARTIAL HOSPITAL PROGRAM MH ADULT 912 RC facility outpatient 825.00 225 135 454 454 150 212 267 267 450 275 275 286 275 275 225 225 216.79 340 189 225 355 194.1 225 356 356 356 252 216.19 309 175 165 275 275 135 275 250 267 275 194.1 246.56 257.29 200.06 200.06 145 153 246.56 PARTIAL HOSPITAL PROGRAM TRIC ADOL PROC2 912 RC facility outpatient 225.00 225 135 454 454 150 212 267 267 450 275 275 286 275 275 225 225 216.79 340 189 225 355 194.1 225 356 356 356 252 216.19 309 175 165 275 275 135 275 250 267 275 194.1 246.56 257.29 200.06 200.06 145 153 246.56 TELE ADULT CD PARTIAL HOSPITAL PROGRAM 912 RC facility outpatient 825.00 225 135 454 454 150 212 267 267 450 275 275 286 275 275 225 225 216.79 340 189 225 355 194.1 225 356 356 356 252 216.19 309 175 165 275 275 135 275 250 267 275 194.1 246.56 257.29 200.06 200.06 145 153 246.56 TELE PARTIAL HOSPITAL PROGRAM ADOL PSYCH 912 RC facility outpatient 825.00 225 135 454 454 150 212 267 267 450 275 275 286 275 275 225 225 216.79 340 189 225 355 194.1 225 356 356 356 252 216.19 309 175 165 275 275 135 275 250 267 275 194.1 246.56 257.29 200.06 200.06 145 153 246.56 TELE PARTIAL HOSPITAL PROGRAM ADULT MH 912 RC facility outpatient 825.00 225 135 454 454 150 212 267 267 450 275 275 286 275 275 225 225 216.79 340 189 225 355 194.1 225 356 356 356 252 216.19 309 175 165 275 275 135 275 250 267 275 194.1 246.56 257.29 200.06 200.06 145 153 246.56 TRI PARTIAL HOSPITAL PROGRAM ADOL PROC 1 912 RC facility outpatient 225.00 225 135 454 454 150 212 267 267 450 275 275 286 275 275 225 225 216.79 340 189 225 355 194.1 225 356 356 356 252 216.19 309 175 165 275 275 135 275 250 267 275 194.1 246.56 257.29 200.06 200.06 145 153 246.56 PARTIAL HOSPITAL PROGRAM ADOL PSYCH 913 RC facility outpatient 825.00 350 200.06 550 454 402 275 297 428 428 450 275 275 286 275 275 225 225 216.79 550 340 396 225 355 216.79 225 356 356 356 252 216.19 309 350 275 310 310 330 275 280 275 250 267 216.79 330.29 257.29 200.06 200.06 310 310 330 330.29 GROUP THER 45-50 915 RC facility outpatient 225.00 275 200.06 402 402 216.19 275 257.29 200.06 INTENSIVE OUTPATIENT PROGRAM MCR ADUL PROC 2 915 RC facility outpatient 220.00 275 200.06 402 402 216.19 275 257.29 200.06 INTENSIVE OUTPATIENT PROGRAM MCR PROC GRP 1 915 RC facility outpatient 220.00 275 200.06 402 402 216.19 275 257.29 200.06 INTENSIVE OUTPATIENT PROGRAM MCR TH PROCESS 2 915 RC facility outpatient 250.00 275 200.06 402 402 216.19 275 257.29 200.06 OP PROCESS GROUP TX 915 RC facility outpatient 160.00 275 200.06 402 402 216.19 275 257.29 200.06 PARTIAL HOSPITAL PROGRAM MCR TH PROC GRP1 915 RC facility outpatient 225.00 275 200.06 402 402 216.19 275 257.29 200.06 PARTIAL HOSPITAL PROGRAM PROCESS GROUP 1 915 RC facility outpatient 225.00 275 200.06 402 402 216.19 275 257.29 200.06 PROCESS GOALS GROUP 915 RC facility outpatient 90.00 275 200.06 402 402 216.19 275 257.29 200.06 PROCESS GROUP 915 RC facility outpatient 160.00 275 200.06 402 402 216.19 275 257.29 200.06 TH PARTIAL HOSPITAL PROGRAM CD MCR PRC 1 915 RC facility outpatient 325.00 275 200.06 402 402 216.19 275 257.29 200.06 FAMILY THER W/PT 916 RC facility outpatient 160.00 402 402 402 RESIDENTIAL TREATMENT CENTER ADOL <17 UNIT 1 1001 RC facility inpatient 1600.00 330 1500 606 500 550 500 550 650 425 494 494 520 450 450 450 468 350 450 750 750 765 862.95 787.95 600 550 450 450 537 540 898.66 794.39 635 400 440 340 502 610 650 415 605 605 605 461.79 461.79 445 1500 750 450 650 600 515 515 480 725 500 330 550 330 550 416 416 985.88 935.58 841 898.66 898.66 898.66 548 548 530 721 500 600 475 410 750 RESIDENTIAL TREATMENT CENTER SUBACUTE CD 1002 RC facility inpatient 1500.00 330 986 606 500 550 500 550 650 425 494 494 520 450 450 450 468 350 450 750 750 765 862.95 787.95 600 450 450 537 540 635 400 440 340 502 610 415 605 605 605 515 515 480 330 550 330 416 416 985.88 935.58 841 548 548 530 RESIDENTIAL TREATMENT CENTER SUBACUTE CD REHA 1002 RC facility inpatient 1500.00 330 986 606 500 550 500 550 650 425 494 494 520 450 450 450 468 350 450 750 750 765 862.95 787.95 600 450 450 537 540 635 400 440 340 502 610 415 605 605 605 515 515 480 330 550 330 416 416 985.88 935.58 841 548 548 530