hospital_name last_updated_on version hospital_location hospital_address license_number|MI "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated." "Texarkana Behavioral Associates, L.C." 5/31/2024 2.0.0 "Fayetteville, Arkansas" 4253 North Crossover Road license_ AR5043 | MI TRUE 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 ]|[plan_ COMMERCIAL]|negotiated_dollar standard_charge|[payer_AARP ]|[plan_ COMMERCIAL] |negotiated_percentage standard_charge|[payer_AARP ]|[plan_ COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_AARP ]|[plan_ COMMERCIAL] standard_charge|[payer_AARP ]|[plan_ COMMERCIAL] |methodology additional_payer_notes |[payer_AARP ]|[Plan_ COMMERCIAL] standard_charge|[payer_AARP ]|[plan_ MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_AARP ]|[plan_ MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_AARP ]|[plan_ MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_AARP ]|[plan_ MANAGED MEDICARE] standard_charge|[payer_AARP ]|[plan_ MANAGED MEDICARE] |methodology additional_payer_notes |[payer_AARP ]|[Plan_ MANAGED MEDICARE] standard_charge|[payer_AETNA ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_AETNA ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_AETNA ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_AETNA ]|[plan_ HMO/PPO] standard_charge|[payer_AETNA ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_AETNA ]|[Plan_ HMO/PPO] standard_charge|[payer_ALL SAVERS UBH ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_ALL SAVERS UBH ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_ALL SAVERS UBH ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_ALL SAVERS UBH ]|[plan_ HMO/PPO] standard_charge|[payer_ALL SAVERS UBH ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_ALL SAVERS UBH ]|[Plan_ HMO/PPO] standard_charge|[payer_ALLWELL ]|[plan_ MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_ALLWELL ]|[plan_ MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_ALLWELL ]|[plan_ MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_ALLWELL ]|[plan_ MANAGED MEDICARE] standard_charge|[payer_ALLWELL ]|[plan_ MANAGED MEDICARE] |methodology additional_payer_notes |[payer_ALLWELL ]|[Plan_ MANAGED MEDICARE] standard_charge|[payer_AM BETTER OF ARK ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_AM BETTER OF ARK ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_AM BETTER OF ARK ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_AM BETTER OF ARK ]|[plan_ HMO/PPO] standard_charge|[payer_AM BETTER OF ARK ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_AM BETTER OF ARK ]|[Plan_ HMO/PPO] standard_charge|[payer_AMBETTER COMMERCIAL ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_AMBETTER COMMERCIAL ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_AMBETTER COMMERCIAL ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_AMBETTER COMMERCIAL ]|[plan_ HMO/PPO] standard_charge|[payer_AMBETTER COMMERCIAL ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_AMBETTER COMMERCIAL ]|[Plan_ HMO/PPO] standard_charge|[payer_AMBETTER NETWORK ACCESS ]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_AMBETTER NETWORK ACCESS ]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_AMBETTER NETWORK ACCESS ]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_AMBETTER NETWORK ACCESS ]|[plan_HMO/PPO] standard_charge|[payer_AMBETTER NETWORK ACCESS ]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_AMBETTER NETWORK ACCESS ]|[Plan_HMO/PPO] standard_charge|[payer_ARKANSAS MEDICAID ]|[plan_ MEDICAID]|negotiated_dollar standard_charge|[payer_ARKANSAS MEDICAID ]|[plan_ MEDICAID] |negotiated_percentage standard_charge|[payer_ARKANSAS MEDICAID ]|[plan_ MEDICAID] |negotiated_algorithm estimated_amount|[payer_ARKANSAS MEDICAID ]|[plan_ MEDICAID] standard_charge|[payer_ARKANSAS MEDICAID ]|[plan_ MEDICAID] |methodology additional_payer_notes |[payer_ARKANSAS MEDICAID ]|[Plan_ MEDICAID] standard_charge|[payer_ARKANSAS TOTAL CARE ]|[plan_ MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_ARKANSAS TOTAL CARE ]|[plan_ MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_ARKANSAS TOTAL CARE ]|[plan_ MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_ARKANSAS TOTAL CARE ]|[plan_ MANAGED MEDICAID] standard_charge|[payer_ARKANSAS TOTAL CARE ]|[plan_ MANAGED MEDICAID] |methodology additional_payer_notes |[payer_ARKANSAS TOTAL CARE ]|[Plan_ MANAGED MEDICAID] standard_charge|[payer_BCBS FEDERAL ]|[plan_ BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS FEDERAL ]|[plan_ BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS FEDERAL ]|[plan_ BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS FEDERAL ]|[plan_ BLUE CROSS] standard_charge|[payer_BCBS FEDERAL ]|[plan_ BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS FEDERAL ]|[Plan_ BLUE CROSS] standard_charge|[payer_BCBS MARKETPLACE ]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS MARKETPLACE ]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS MARKETPLACE ]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS MARKETPLACE ]|[plan_BLUE CROSS] standard_charge|[payer_BCBS MARKETPLACE ]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS MARKETPLACE ]|[Plan_BLUE CROSS] standard_charge|[payer_BCBS MEDIPAK ]|[plan_ BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS MEDIPAK ]|[plan_ BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS MEDIPAK ]|[plan_ BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS MEDIPAK ]|[plan_ BLUE CROSS] standard_charge|[payer_BCBS MEDIPAK ]|[plan_ BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS MEDIPAK ]|[Plan_ BLUE CROSS] standard_charge|[payer_BCBS OUT OF STATE ]|[plan_ BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS OUT OF STATE ]|[plan_ BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS OUT OF STATE ]|[plan_ BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS OUT OF STATE ]|[plan_ BLUE CROSS] standard_charge|[payer_BCBS OUT OF STATE ]|[plan_ BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS OUT OF STATE ]|[Plan_ BLUE CROSS] standard_charge|[payer_BEACON HEALTH OPTIONS ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_BEACON HEALTH OPTIONS ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_BEACON HEALTH OPTIONS ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_BEACON HEALTH OPTIONS ]|[plan_ HMO/PPO] standard_charge|[payer_BEACON HEALTH OPTIONS ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_BEACON HEALTH OPTIONS ]|[Plan_ HMO/PPO] standard_charge|[payer_BLUE ADVANTAGE ]|[plan_ BLUE CROSS]|negotiated_dollar standard_charge|[payer_BLUE ADVANTAGE ]|[plan_ BLUE CROSS] |negotiated_percentage standard_charge|[payer_BLUE ADVANTAGE ]|[plan_ BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BLUE ADVANTAGE ]|[plan_ BLUE CROSS] standard_charge|[payer_BLUE ADVANTAGE ]|[plan_ BLUE CROSS] |methodology additional_payer_notes |[payer_BLUE ADVANTAGE ]|[Plan_ BLUE CROSS] standard_charge|[payer_BLUE CROSS BLUE SHIELD ]|[plan_ BLUE CROSS]|negotiated_dollar standard_charge|[payer_BLUE CROSS BLUE SHIELD ]|[plan_ BLUE CROSS] |negotiated_percentage standard_charge|[payer_BLUE CROSS BLUE SHIELD ]|[plan_ BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BLUE CROSS BLUE SHIELD ]|[plan_ BLUE CROSS] standard_charge|[payer_BLUE CROSS BLUE SHIELD ]|[plan_ BLUE CROSS] |methodology additional_payer_notes |[payer_BLUE CROSS BLUE SHIELD ]|[Plan_ BLUE CROSS] standard_charge|[payer_CARE IMPROVEMENT ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_CARE IMPROVEMENT ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_CARE IMPROVEMENT ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_CARE IMPROVEMENT ]|[plan_ HMO/PPO] standard_charge|[payer_CARE IMPROVEMENT ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_CARE IMPROVEMENT ]|[Plan_ HMO/PPO] standard_charge|[payer_CARE IMPROVEMENT ]|[plan_ MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_CARE IMPROVEMENT ]|[plan_ MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_CARE IMPROVEMENT ]|[plan_ MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_CARE IMPROVEMENT ]|[plan_ MANAGED MEDICARE] standard_charge|[payer_CARE IMPROVEMENT ]|[plan_ MANAGED MEDICARE] |methodology additional_payer_notes |[payer_CARE IMPROVEMENT ]|[Plan_ MANAGED MEDICARE] standard_charge|[payer_CARESOURCE ]|[plan_ MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_CARESOURCE ]|[plan_ MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_CARESOURCE ]|[plan_ MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_CARESOURCE ]|[plan_ MANAGED MEDICAID] standard_charge|[payer_CARESOURCE ]|[plan_ MANAGED MEDICAID] |methodology additional_payer_notes |[payer_CARESOURCE ]|[Plan_ MANAGED MEDICAID] standard_charge|[payer_CHAMPVA ]|[plan_ VETERANS ADMIN]|negotiated_dollar standard_charge|[payer_CHAMPVA ]|[plan_ VETERANS ADMIN] |negotiated_percentage standard_charge|[payer_CHAMPVA ]|[plan_ VETERANS ADMIN] |negotiated_algorithm estimated_amount|[payer_CHAMPVA ]|[plan_ VETERANS ADMIN] standard_charge|[payer_CHAMPVA ]|[plan_ VETERANS ADMIN] |methodology additional_payer_notes |[payer_CHAMPVA ]|[Plan_ VETERANS ADMIN] standard_charge|[payer_CIGNA ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_CIGNA ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_CIGNA ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_CIGNA ]|[plan_ HMO/PPO] standard_charge|[payer_CIGNA ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_CIGNA ]|[Plan_ HMO/PPO] standard_charge|[payer_CIGNA MEDICARE ]|[plan_ MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_CIGNA MEDICARE ]|[plan_ MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_CIGNA MEDICARE ]|[plan_ MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_CIGNA MEDICARE ]|[plan_ MANAGED MEDICARE] standard_charge|[payer_CIGNA MEDICARE ]|[plan_ MANAGED MEDICARE] |methodology additional_payer_notes |[payer_CIGNA MEDICARE ]|[Plan_ MANAGED MEDICARE] standard_charge|[payer_CIGNA- OPTUM BH ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_CIGNA- OPTUM BH ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_CIGNA- OPTUM BH ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_CIGNA- OPTUM BH ]|[plan_ HMO/PPO] standard_charge|[payer_CIGNA- OPTUM BH ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_CIGNA- OPTUM BH ]|[Plan_ HMO/PPO] standard_charge|[payer_COUNSELING ASSOCIATES ]|[plan_ LOCAL GOVT]|negotiated_dollar standard_charge|[payer_COUNSELING ASSOCIATES ]|[plan_ LOCAL GOVT] |negotiated_percentage standard_charge|[payer_COUNSELING ASSOCIATES ]|[plan_ LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_COUNSELING ASSOCIATES ]|[plan_ LOCAL GOVT] standard_charge|[payer_COUNSELING ASSOCIATES ]|[plan_ LOCAL GOVT] |methodology additional_payer_notes |[payer_COUNSELING ASSOCIATES ]|[Plan_ LOCAL GOVT] standard_charge|[payer_COUNSELING CLINIC ]|[plan_ LOCAL GOVT]|negotiated_dollar standard_charge|[payer_COUNSELING CLINIC ]|[plan_ LOCAL GOVT] |negotiated_percentage standard_charge|[payer_COUNSELING CLINIC ]|[plan_ LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_COUNSELING CLINIC ]|[plan_ LOCAL GOVT] standard_charge|[payer_COUNSELING CLINIC ]|[plan_ LOCAL GOVT] |methodology additional_payer_notes |[payer_COUNSELING CLINIC ]|[Plan_ LOCAL GOVT] standard_charge|[payer_COVENTRY ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_COVENTRY ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_COVENTRY ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_COVENTRY ]|[plan_ HMO/PPO] standard_charge|[payer_COVENTRY ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_COVENTRY ]|[Plan_ HMO/PPO] standard_charge|[payer_COVENTRY ]|[plan_ MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_COVENTRY ]|[plan_ MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_COVENTRY ]|[plan_ MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_COVENTRY ]|[plan_ MANAGED MEDICARE] standard_charge|[payer_COVENTRY ]|[plan_ MANAGED MEDICARE] |methodology additional_payer_notes |[payer_COVENTRY ]|[Plan_ MANAGED MEDICARE] standard_charge|[payer_COVENTRY ADVANTRA PPO ]|[plan_ MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_COVENTRY ADVANTRA PPO ]|[plan_ MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_COVENTRY ADVANTRA PPO ]|[plan_ MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_COVENTRY ADVANTRA PPO ]|[plan_ MANAGED MEDICARE] standard_charge|[payer_COVENTRY ADVANTRA PPO ]|[plan_ MANAGED MEDICARE] |methodology additional_payer_notes |[payer_COVENTRY ADVANTRA PPO ]|[Plan_ MANAGED MEDICARE] standard_charge|[payer_COVENTRY TOTAL CARE HMO ]|[plan_ MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_COVENTRY TOTAL CARE HMO ]|[plan_ MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_COVENTRY TOTAL CARE HMO ]|[plan_ MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_COVENTRY TOTAL CARE HMO ]|[plan_ MANAGED MEDICARE] standard_charge|[payer_COVENTRY TOTAL CARE HMO ]|[plan_ MANAGED MEDICARE] |methodology additional_payer_notes |[payer_COVENTRY TOTAL CARE HMO ]|[Plan_ MANAGED MEDICARE] standard_charge|[payer_DEPT CHILD & FAMILY SRVCS ]|[plan_ LOCAL GOVT]|negotiated_dollar standard_charge|[payer_DEPT CHILD & FAMILY SRVCS ]|[plan_ LOCAL GOVT] |negotiated_percentage standard_charge|[payer_DEPT CHILD & FAMILY SRVCS ]|[plan_ LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_DEPT CHILD & FAMILY SRVCS ]|[plan_ LOCAL GOVT] standard_charge|[payer_DEPT CHILD & FAMILY SRVCS ]|[plan_ LOCAL GOVT] |methodology additional_payer_notes |[payer_DEPT CHILD & FAMILY SRVCS ]|[Plan_ LOCAL GOVT] standard_charge|[payer_EDS OKLAHOMA MEDICAID ]|[plan_ MEDICAID: OUT OF STATE]|negotiated_dollar standard_charge|[payer_EDS OKLAHOMA MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_percentage standard_charge|[payer_EDS OKLAHOMA MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_algorithm estimated_amount|[payer_EDS OKLAHOMA MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_EDS OKLAHOMA MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |methodology additional_payer_notes |[payer_EDS OKLAHOMA MEDICAID ]|[Plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_EMPOWER ]|[plan_ MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_EMPOWER ]|[plan_ MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_EMPOWER ]|[plan_ MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_EMPOWER ]|[plan_ MANAGED MEDICAID] standard_charge|[payer_EMPOWER ]|[plan_ MANAGED MEDICAID] |methodology additional_payer_notes |[payer_EMPOWER ]|[Plan_ MANAGED MEDICAID] standard_charge|[payer_GEHA ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_GEHA ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_GEHA ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_GEHA ]|[plan_ HMO/PPO] standard_charge|[payer_GEHA ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_GEHA ]|[Plan_ HMO/PPO] standard_charge|[payer_GREAT WEST ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_GREAT WEST ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_GREAT WEST ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_GREAT WEST ]|[plan_ HMO/PPO] standard_charge|[payer_GREAT WEST ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_GREAT WEST ]|[Plan_ HMO/PPO] standard_charge|[payer_HEALTH ADVANTAGE ]|[plan_ BLUE CROSS]|negotiated_dollar standard_charge|[payer_HEALTH ADVANTAGE ]|[plan_ BLUE CROSS] |negotiated_percentage standard_charge|[payer_HEALTH ADVANTAGE ]|[plan_ BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_HEALTH ADVANTAGE ]|[plan_ BLUE CROSS] standard_charge|[payer_HEALTH ADVANTAGE ]|[plan_ BLUE CROSS] |methodology additional_payer_notes |[payer_HEALTH ADVANTAGE ]|[Plan_ BLUE CROSS] standard_charge|[payer_HEALTH PARTNERS ]|[plan_ COMMERCIAL]|negotiated_dollar standard_charge|[payer_HEALTH PARTNERS ]|[plan_ COMMERCIAL] |negotiated_percentage standard_charge|[payer_HEALTH PARTNERS ]|[plan_ COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_HEALTH PARTNERS ]|[plan_ COMMERCIAL] standard_charge|[payer_HEALTH PARTNERS ]|[plan_ COMMERCIAL] |methodology additional_payer_notes |[payer_HEALTH PARTNERS ]|[Plan_ COMMERCIAL] standard_charge|[payer_HEALTHSCOPE ]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_HEALTHSCOPE ]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_HEALTHSCOPE ]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_HEALTHSCOPE ]|[plan_HMO/PPO] standard_charge|[payer_HEALTHSCOPE ]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_HEALTHSCOPE ]|[Plan_HMO/PPO] standard_charge|[payer_HOME STATE HEALTH PLAN IN ]|[plan_ MEDICAID: OUT OF STATE]|negotiated_dollar standard_charge|[payer_HOME STATE HEALTH PLAN IN ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_percentage standard_charge|[payer_HOME STATE HEALTH PLAN IN ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_algorithm estimated_amount|[payer_HOME STATE HEALTH PLAN IN ]|[plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_HOME STATE HEALTH PLAN IN ]|[plan_ MEDICAID: OUT OF STATE] |methodology additional_payer_notes |[payer_HOME STATE HEALTH PLAN IN ]|[Plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_HUMANA ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_HUMANA ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_HUMANA ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_HUMANA ]|[plan_ HMO/PPO] standard_charge|[payer_HUMANA ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_HUMANA ]|[Plan_ HMO/PPO] standard_charge|[payer_HUMANA MANAGED MEDICARE ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_HUMANA MANAGED MEDICARE ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_HUMANA MANAGED MEDICARE ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_HUMANA MANAGED MEDICARE ]|[plan_ HMO/PPO] standard_charge|[payer_HUMANA MANAGED MEDICARE ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_HUMANA MANAGED MEDICARE ]|[Plan_ HMO/PPO] standard_charge|[payer_LIFESYNCH ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_LIFESYNCH ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_LIFESYNCH ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_LIFESYNCH ]|[plan_ HMO/PPO] standard_charge|[payer_LIFESYNCH ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_LIFESYNCH ]|[Plan_ HMO/PPO] standard_charge|[payer_LIFESYNCH HUMANA ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_LIFESYNCH HUMANA ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_LIFESYNCH HUMANA ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_LIFESYNCH HUMANA ]|[plan_ HMO/PPO] standard_charge|[payer_LIFESYNCH HUMANA ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_LIFESYNCH HUMANA ]|[Plan_ HMO/PPO] standard_charge|[payer_MEDICAID ADULTS ]|[plan_ MEDICAID]|negotiated_dollar standard_charge|[payer_MEDICAID ADULTS ]|[plan_ MEDICAID] |negotiated_percentage standard_charge|[payer_MEDICAID ADULTS ]|[plan_ MEDICAID] |negotiated_algorithm estimated_amount|[payer_MEDICAID ADULTS ]|[plan_ MEDICAID] standard_charge|[payer_MEDICAID ADULTS ]|[plan_ MEDICAID] |methodology additional_payer_notes |[payer_MEDICAID ADULTS ]|[Plan_ MEDICAID] standard_charge|[payer_MERITAIN HEALTH ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_MERITAIN HEALTH ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_MERITAIN HEALTH ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MERITAIN HEALTH ]|[plan_ HMO/PPO] standard_charge|[payer_MERITAIN HEALTH ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_MERITAIN HEALTH ]|[Plan_ HMO/PPO] standard_charge|[payer_MHNET ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_MHNET ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_MHNET ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MHNET ]|[plan_ HMO/PPO] standard_charge|[payer_MHNET ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_MHNET ]|[Plan_ HMO/PPO] standard_charge|[payer_MISSOURI CARE ]|[plan_ MEDICAID: OUT OF STATE]|negotiated_dollar standard_charge|[payer_MISSOURI CARE ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_percentage standard_charge|[payer_MISSOURI CARE ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_algorithm estimated_amount|[payer_MISSOURI CARE ]|[plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_MISSOURI CARE ]|[plan_ MEDICAID: OUT OF STATE] |methodology additional_payer_notes |[payer_MISSOURI CARE ]|[Plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_MISSOURI MEDICAID ]|[plan_ MEDICAID: OUT OF STATE]|negotiated_dollar standard_charge|[payer_MISSOURI MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_percentage standard_charge|[payer_MISSOURI MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_algorithm estimated_amount|[payer_MISSOURI MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_MISSOURI MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |methodology additional_payer_notes |[payer_MISSOURI MEDICAID ]|[Plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_MUNICIPAL HEALTH BEN FUND ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_MUNICIPAL HEALTH BEN FUND ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_MUNICIPAL HEALTH BEN FUND ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MUNICIPAL HEALTH BEN FUND ]|[plan_ HMO/PPO] standard_charge|[payer_MUNICIPAL HEALTH BEN FUND ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_MUNICIPAL HEALTH BEN FUND ]|[Plan_ HMO/PPO] standard_charge|[payer_MUTUAL OF OMAHA ]|[plan_ COMMERCIAL]|negotiated_dollar standard_charge|[payer_MUTUAL OF OMAHA ]|[plan_ COMMERCIAL] |negotiated_percentage standard_charge|[payer_MUTUAL OF OMAHA ]|[plan_ COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_MUTUAL OF OMAHA ]|[plan_ COMMERCIAL] standard_charge|[payer_MUTUAL OF OMAHA ]|[plan_ COMMERCIAL] |methodology additional_payer_notes |[payer_MUTUAL OF OMAHA ]|[Plan_ COMMERCIAL] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_OPTUM BEHAVIORAL HEALTH ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_OPTUM BEHAVIORAL HEALTH ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_OPTUM BEHAVIORAL HEALTH ]|[plan_ HMO/PPO] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_OPTUM BEHAVIORAL HEALTH ]|[Plan_ HMO/PPO] standard_charge|[payer_OZARK GUIDANCE CENTER ]|[plan_ LOCAL GOVT]|negotiated_dollar standard_charge|[payer_OZARK GUIDANCE CENTER ]|[plan_ LOCAL GOVT] |negotiated_percentage standard_charge|[payer_OZARK GUIDANCE CENTER ]|[plan_ LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_OZARK GUIDANCE CENTER ]|[plan_ LOCAL GOVT] standard_charge|[payer_OZARK GUIDANCE CENTER ]|[plan_ LOCAL GOVT] |methodology additional_payer_notes |[payer_OZARK GUIDANCE CENTER ]|[Plan_ LOCAL GOVT] standard_charge|[payer_PEND AR MEDICAID ]|[plan_ PENDING MEDICAID]|negotiated_dollar standard_charge|[payer_PEND AR MEDICAID ]|[plan_ PENDING MEDICAID] |negotiated_percentage standard_charge|[payer_PEND AR MEDICAID ]|[plan_ PENDING MEDICAID] |negotiated_algorithm estimated_amount|[payer_PEND AR MEDICAID ]|[plan_ PENDING MEDICAID] standard_charge|[payer_PEND AR MEDICAID ]|[plan_ PENDING MEDICAID] |methodology additional_payer_notes |[payer_PEND AR MEDICAID ]|[Plan_ PENDING MEDICAID] standard_charge|[payer_QUALCHOICE ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_QUALCHOICE ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_QUALCHOICE ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_QUALCHOICE ]|[plan_ HMO/PPO] standard_charge|[payer_QUALCHOICE ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_QUALCHOICE ]|[Plan_ HMO/PPO] standard_charge|[payer_SUMMIT COMMUNITY CARE ]|[plan_ MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_SUMMIT COMMUNITY CARE ]|[plan_ MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_SUMMIT COMMUNITY CARE ]|[plan_ MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_SUMMIT COMMUNITY CARE ]|[plan_ MANAGED MEDICAID] standard_charge|[payer_SUMMIT COMMUNITY CARE ]|[plan_ MANAGED MEDICAID] |methodology additional_payer_notes |[payer_SUMMIT COMMUNITY CARE ]|[Plan_ MANAGED MEDICAID] standard_charge|[payer_TRICARE FOR LIFE ]|[plan_ TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE FOR LIFE ]|[plan_ TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE FOR LIFE ]|[plan_ TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE FOR LIFE ]|[plan_ TRICARE] standard_charge|[payer_TRICARE FOR LIFE ]|[plan_ TRICARE] |methodology additional_payer_notes |[payer_TRICARE FOR LIFE ]|[Plan_ TRICARE] standard_charge|[payer_TRICARE HUMANA MILITARY ]|[plan_ TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE HUMANA MILITARY ]|[plan_ TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE HUMANA MILITARY ]|[plan_ TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE HUMANA MILITARY ]|[plan_ TRICARE] standard_charge|[payer_TRICARE HUMANA MILITARY ]|[plan_ TRICARE] |methodology additional_payer_notes |[payer_TRICARE HUMANA MILITARY ]|[Plan_ TRICARE] standard_charge|[payer_UBH ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_UBH ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_UBH ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UBH ]|[plan_ HMO/PPO] standard_charge|[payer_UBH ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_UBH ]|[Plan_ HMO/PPO] standard_charge|[payer_UHC ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_UHC ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_UHC ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UHC ]|[plan_ HMO/PPO] standard_charge|[payer_UHC ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_UHC ]|[Plan_ HMO/PPO] standard_charge|[payer_UHC MANAGED MEDICAID ]|[plan_ MEDICAID: OUT OF STATE]|negotiated_dollar standard_charge|[payer_UHC MANAGED MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_percentage standard_charge|[payer_UHC MANAGED MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |negotiated_algorithm estimated_amount|[payer_UHC MANAGED MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_UHC MANAGED MEDICAID ]|[plan_ MEDICAID: OUT OF STATE] |methodology additional_payer_notes |[payer_UHC MANAGED MEDICAID ]|[Plan_ MEDICAID: OUT OF STATE] standard_charge|[payer_UHC MANAGED MEDICARE ]|[plan_ MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_UHC MANAGED MEDICARE ]|[plan_ MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_UHC MANAGED MEDICARE ]|[plan_ MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_UHC MANAGED MEDICARE ]|[plan_ MANAGED MEDICARE] standard_charge|[payer_UHC MANAGED MEDICARE ]|[plan_ MANAGED MEDICARE] |methodology additional_payer_notes |[payer_UHC MANAGED MEDICARE ]|[Plan_ MANAGED MEDICARE] standard_charge|[payer_UHC SHARED SERVICES GEHA ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_UHC SHARED SERVICES GEHA ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_UHC SHARED SERVICES GEHA ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UHC SHARED SERVICES GEHA ]|[plan_ HMO/PPO] standard_charge|[payer_UHC SHARED SERVICES GEHA ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_UHC SHARED SERVICES GEHA ]|[Plan_ HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURCES ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_UHC STUDENT RESOURCES ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_UHC STUDENT RESOURCES ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UHC STUDENT RESOURCES ]|[plan_ HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURCES ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_UHC STUDENT RESOURCES ]|[Plan_ HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURE ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_UHC STUDENT RESOURE ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_UHC STUDENT RESOURE ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UHC STUDENT RESOURE ]|[plan_ HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURE ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_UHC STUDENT RESOURE ]|[Plan_ HMO/PPO] standard_charge|[payer_UH-ONE GOLDEN RULE ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_UH-ONE GOLDEN RULE ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_UH-ONE GOLDEN RULE ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UH-ONE GOLDEN RULE ]|[plan_ HMO/PPO] standard_charge|[payer_UH-ONE GOLDEN RULE ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_UH-ONE GOLDEN RULE ]|[Plan_ HMO/PPO] standard_charge|[payer_UMR ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_UMR ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_UMR ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UMR ]|[plan_ HMO/PPO] standard_charge|[payer_UMR ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_UMR ]|[Plan_ HMO/PPO] standard_charge|[payer_VETERANS ADMINISTRATION ]|[plan_ VETERANS ADMIN]|negotiated_dollar standard_charge|[payer_VETERANS ADMINISTRATION ]|[plan_ VETERANS ADMIN] |negotiated_percentage standard_charge|[payer_VETERANS ADMINISTRATION ]|[plan_ VETERANS ADMIN] |negotiated_algorithm estimated_amount|[payer_VETERANS ADMINISTRATION ]|[plan_ VETERANS ADMIN] standard_charge|[payer_VETERANS ADMINISTRATION ]|[plan_ VETERANS ADMIN] |methodology additional_payer_notes |[payer_VETERANS ADMINISTRATION ]|[Plan_ VETERANS ADMIN] standard_charge|[payer_WEB TPA AETNA ]|[plan_ HMO/PPO]|negotiated_dollar standard_charge|[payer_WEB TPA AETNA ]|[plan_ HMO/PPO] |negotiated_percentage standard_charge|[payer_WEB TPA AETNA ]|[plan_ HMO/PPO] |negotiated_algorithm estimated_amount|[payer_WEB TPA AETNA ]|[plan_ HMO/PPO] standard_charge|[payer_WEB TPA AETNA ]|[plan_ HMO/PPO] |methodology additional_payer_notes |[payer_WEB TPA AETNA ]|[Plan_ HMO/PPO] standard_charge|[payer_WESTERN AR GUIDANCE CTR ]|[plan_ LOCAL GOVT]|negotiated_dollar standard_charge|[payer_WESTERN AR GUIDANCE CTR ]|[plan_ LOCAL GOVT] |negotiated_percentage standard_charge|[payer_WESTERN AR GUIDANCE CTR ]|[plan_ LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_WESTERN AR GUIDANCE CTR ]|[plan_ LOCAL GOVT] standard_charge|[payer_WESTERN AR GUIDANCE CTR ]|[plan_ LOCAL GOVT] |methodology additional_payer_notes |[payer_WESTERN AR GUIDANCE CTR ]|[Plan_ LOCAL GOVT] additional_generic_notes ROOM AND BOARD CHILD ACUTE 124 RC facility Inpatient 1725 600 400 1158 738 per diem 1000 per diem 738 per diem 840 per diem 924 per diem 1062 per diem 694 per Diem 694 per Diem 700 per Diem 798 per Diem 759 per Diem 737 per Diem 759 per Diem 759 per Diem 738 per Diem 738 per Diem 694 per Diem 1019 per Diem 1019 per Diem 400 per Diem 450 per Diem 814 per Diem 814 per Diem 814 per Diem 1158 per diem 596 per diem 694 per diem 738 per diem 950 per diem 759 per diem 980 per diem 814 per diem 974 per diem 906 per diem 906 per diem 600 per diem 941 per diem 785 per diem 1052 per diem 1052 per diem 1000 per diem 738 per diem 400 per diem 694 per diem 797 per diem 694 per diem 818.55 per diem 818.55 per diem 738 per diem 738 per diem 1052 per diem 738 per diem 738 per diem 738 per diem 738 per diem 738 per diem 963 per diem 941 per diem 494 per diem ROOM AND BOARD GERO UNIT 124 RC facility Inpatient 1725 600 400 1158 738 per diem 1000 per diem 738 per diem 840 per diem 924 per diem 1062 per diem 694 per Diem 694 per Diem 700 per Diem 798 per Diem 759 per Diem 737 per Diem 759 per Diem 759 per Diem 738 per Diem 738 per Diem 694 per Diem 1019 per Diem 1019 per Diem 400 per Diem 450 per Diem 814 per Diem 814 per Diem 814 per Diem 1158 per diem 596 per diem 694 per diem 738 per diem 950 per diem 759 per diem 980 per diem 814 per diem 974 per diem 906 per diem 906 per diem 600 per diem 941 per diem 785 per diem 1052 per diem 1052 per diem 1000 per diem 738 per diem 400 per diem 694 per diem 797 per diem 694 per diem 818.55 per diem 818.55 per diem 738 per diem 738 per diem 1052 per diem 738 per diem 738 per diem 738 per diem 738 per diem 738 per diem 963 per diem 941 per diem 494 per diem ROOM AND BOARD PSYCH ADO UNIT 124 RC facility Inpatient 1725 600 400 1158 738 per diem 1000 per diem 738 per diem 840 per diem 924 per diem 1062 per diem 694 per Diem 694 per Diem 700 per Diem 798 per Diem 759 per Diem 737 per Diem 759 per Diem 759 per Diem 738 per Diem 738 per Diem 694 per Diem 1019 per Diem 1019 per Diem 400 per Diem 450 per Diem 814 per Diem 814 per Diem 814 per Diem 1158 per diem 596 per diem 694 per diem 738 per diem 950 per diem 759 per diem 980 per diem 814 per diem 974 per diem 906 per diem 906 per diem 600 per diem 941 per diem 785 per diem 1052 per diem 1052 per diem 1000 per diem 738 per diem 400 per diem 694 per diem 797 per diem 694 per diem 818.55 per diem 818.55 per diem 738 per diem 738 per diem 1052 per diem 738 per diem 738 per diem 738 per diem 738 per diem 738 per diem 963 per diem 941 per diem 494 per diem ROOM AND BOARD PSYCH ADULT 124 RC facility Inpatient 1725 600 400 1158 738 per diem 1000 per diem 738 per diem 840 per diem 924 per diem 1062 per diem 694 per Diem 694 per Diem 700 per Diem 798 per Diem 759 per Diem 737 per Diem 759 per Diem 759 per Diem 738 per Diem 738 per Diem 694 per Diem 1019 per Diem 1019 per Diem 400 per Diem 450 per Diem 814 per Diem 814 per Diem 814 per Diem 1158 per diem 596 per diem 694 per diem 738 per diem 950 per diem 759 per diem 980 per diem 814 per diem 974 per diem 906 per diem 906 per diem 600 per diem 941 per diem 785 per diem 1052 per diem 1052 per diem 1000 per diem 738 per diem 400 per diem 694 per diem 797 per diem 694 per diem 818.55 per diem 818.55 per diem 738 per diem 738 per diem 1052 per diem 738 per diem 738 per diem 738 per diem 738 per diem 738 per diem 963 per diem 941 per diem 494 per diem ROOM AND BOARD ADULT DETOX 126 RC facility Inpatient 1725 600 400 1158 738 per diem 1000 per diem 738 per diem 840 per diem 924 per diem 1062 per diem 590 per Diem 798 per Diem 759 per Diem 628 per Diem 759 per Diem 759 per Diem 738 per Diem 963 per Diem 1019 per Diem 1019 per Diem 450 per Diem 814 per Diem 814 per Diem 814 per Diem 1158 per diem 738 per diem 950 per diem 759 per diem 980 per diem 814 per diem 906 per diem 906 per diem 600 per diem 901 per diem 654 per diem 738 per diem 400 per diem 797 per diem 818.55 per diem 818.55 per diem 738 per diem 738 per diem 738 per diem 738 per diem 738 per diem 738 per diem 738 per diem 901 per diem 494 per diem ROOM AND BOARD REBAH CD 128 RC facility Inpatient 1725 500 520 1019 738 per diem 1000 per diem 738 per diem 725 per diem 797 per diem 917 per diem 700 per Diem 798 per Diem 759 per Diem 759 per Diem 759 per Diem 1019 per Diem 1019 per Diem 520 per Diem 520 per Diem 759 per diem 618 per diem 738 per diem 738 per diem 738 per diem 738 per diem 901 per diem ROOM AND BOARD PSYCH ADO RTU 129 RC facility Inpatient 1020 399 293 1000 750 per diem 560 per diem 597 per Diem 597 per Diem 500 per Diem 508 per Diem 508 per Diem 492 per Diem 508 per Diem 508 per Diem 560 per Diem 597 per Diem 782 per Diem 782 per Diem 520 per Diem 520 per Diem 508 per diem 293 per diem 597 per diem 560 per diem 730 per diem 508 per diem 752 per diem 520 per diem 373 per diem 618 per diem 618 per diem 694 per diem 585 per diem 373 per diem 373 per diem 1000 per diem 560 per diem 597 per diem 363 per diem 597 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 694 per diem ROOM AND BOARD PSYCH CHILD RTU 129 RC facility Inpatient 1020 399 293 1000 750 per diem 560 per diem 597 per Diem 597 per Diem 500 per Diem 508 per Diem 508 per Diem 492 per Diem 508 per Diem 508 per Diem 560 per Diem 597 per Diem 782 per Diem 782 per Diem 520 per Diem 520 per Diem 508 per diem 293 per diem 597 per diem 560 per diem 730 per diem 508 per diem 752 per diem 520 per diem 373 per diem 618 per diem 694 per diem 585 per diem 373 per diem 373 per diem 1000 per diem 560 per diem 597 per diem 363 per diem 597 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 694 per diem INTENSIVE OUTPATIENT PROGRAM ADULT PROGRAM 905 RC facility Outpatient 225 150 126 232 137 per diem 200 per diem 137 per diem 203 per diem 126 per diem 138 per diem 159 per diem 150 per Diem 162 per Diem 189 per Diem 202 per Diem 202 per Diem 162 per Diem 137 per Diem 137 per Diem 180 per Diem 187.92 per Diem 180 per Diem 175 per Diem 175 per Diem 175 per Diem 175 per Diem 168 per diem 168 per diem 162 per diem 225 per diem 232 per diem 232 per diem 195 per diem 128 per diem 137 per diem 132 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem INTENSIVE OUTPATIENT PROGRAM GROUP PROGRAM 905 RC facility Outpatient 225 150 126 232 137 per diem 200 per diem 137 per diem 203 per diem 126 per diem 138 per diem 159 per diem 150 per Diem 162 per Diem 189 per Diem 202 per Diem 202 per Diem 162 per Diem 137 per Diem 137 per Diem 180 per Diem 187.92 per Diem 180 per Diem 175 per Diem 175 per Diem 175 per Diem 175 per Diem 168 per diem 168 per diem 162 per diem 225 per diem 232 per diem 232 per diem 195 per diem 128 per diem 137 per diem 132 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem TELE INTENSIVE OUTPATIENT PROGRAM ADULT 905 RC facility Outpatient 225 150 126 232 200 per diem 137 per diem 203 per diem 126 per diem 138 per diem 159 per diem 150 per Diem 162 per Diem 189 per Diem 202 per Diem 202 per Diem 162 per Diem 137 per Diem 137 per Diem 180 per Diem 187.92 per Diem 180 per Diem 175 per Diem 175 per Diem 175 per Diem 175 per Diem 168 per diem 168 per diem 162 per diem 225 per diem 232 per diem 232 per diem 195 per diem 128 per diem 137 per diem 132 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem 137 per diem CD INTENSIVE OUTPATIENT PROGRAM ADULT PROGRAM 906 RC facility Outpatient 225 150 126 187.92 137 per diem 137 per diem 126 per diem 138 per diem 159 per diem 180 per Diem 187.92 per Diem 180 per Diem 132 per diem