"hospital_Greenleaf Center, LLC, LLC" last_updated_ 2023-12-31 version_1 "hospital_Valdosta, Georgia" hospital_address 2209 Pineview Drive license_ 092-686 | GA "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 ADVANTAGE MANAGED MEDICARE] standard_charge|[payer_AARP MEDICARE ADVANTAGE MANAGED MEDICARE] |percent standard_charge|[payer_AARP MEDICARE ADVANTAGE MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AARP MEDICARE ADVANTAGE MANAGED MEDICARE] standard_charge|[payer_AARP UHC HMO/PPO] standard_charge|[payer_AARP UHC HMO/PPO] |percent standard_charge|[payer_AARP UHC HMO/PPO] |contracting_method additional_payer_notes |[payer_AARP UHC HMO/PPO] standard_charge|[payer_ADMINISTRATION CONCEPTS COMMERCIAL] standard_charge|[payer_ADMINISTRATION CONCEPTS COMMERCIAL] |percent standard_charge|[payer_ADMINISTRATION CONCEPTS COMMERCIAL] |contracting_method additional_payer_notes |[payer_ADMINISTRATION CONCEPTS 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 ADV|MANAGED MEDICARE] standard_charge|[payer_AETNA MEDICARE ADV|MANAGED MEDICARE] |percent standard_charge|[payer_AETNA MEDICARE ADV|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA MEDICARE ADV|MANAGED MEDICARE] standard_charge|[payer_ALL SAVERS HEALTH PLAN|HMO/PPO] standard_charge|[payer_ALL SAVERS HEALTH PLAN|HMO/PPO] |percent standard_charge|[payer_ALL SAVERS HEALTH PLAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALL SAVERS HEALTH PLAN|HMO/PPO] standard_charge|[payer_ALLIANT HEALTH PLAN|HMO/PPO] standard_charge|[payer_ALLIANT HEALTH PLAN|HMO/PPO] |percent standard_charge|[payer_ALLIANT HEALTH PLAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALLIANT HEALTH PLAN|HMO/PPO] standard_charge|[payer_ALLIED BENEFIT|HMO/PPO] standard_charge|[payer_ALLIED BENEFIT|HMO/PPO] |percent standard_charge|[payer_ALLIED BENEFIT|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALLIED BENEFIT|HMO/PPO] standard_charge|[payer_ALLIED NATIONAL|HMO/PPO] standard_charge|[payer_ALLIED NATIONAL|HMO/PPO] |percent standard_charge|[payer_ALLIED NATIONAL|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALLIED NATIONAL|HMO/PPO] standard_charge|[payer_ALLIED NATIONAL GLOBAL IN|COMMERCIAL] standard_charge|[payer_ALLIED NATIONAL GLOBAL IN|COMMERCIAL] |percent standard_charge|[payer_ALLIED NATIONAL GLOBAL IN|COMMERCIAL] |contracting_method additional_payer_notes |[payer_ALLIED NATIONAL GLOBAL IN|COMMERCIAL] standard_charge|[payer_ALLWELL DUAL MEDICARE|MANAGED MEDICARE] standard_charge|[payer_ALLWELL DUAL MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_ALLWELL DUAL MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_ALLWELL DUAL MEDICARE|MANAGED MEDICARE] standard_charge|[payer_AMBETTER BY PEACHSTATE|HMO/PPO] standard_charge|[payer_AMBETTER BY PEACHSTATE|HMO/PPO] |percent standard_charge|[payer_AMBETTER BY PEACHSTATE|HMO/PPO] |contracting_method additional_payer_notes |[payer_AMBETTER BY PEACHSTATE|HMO/PPO] standard_charge|[payer_AMERICAN HEALTH GROUP INC|COMMERCIAL] standard_charge|[payer_AMERICAN HEALTH GROUP INC|COMMERCIAL] |percent standard_charge|[payer_AMERICAN HEALTH GROUP INC|COMMERCIAL] |contracting_method additional_payer_notes |[payer_AMERICAN HEALTH GROUP INC|COMMERCIAL] standard_charge|[payer_AMERIGROUP COMM CARE|MANAGED MEDICAID] standard_charge|[payer_AMERIGROUP COMM CARE|MANAGED MEDICAID] |percent standard_charge|[payer_AMERIGROUP COMM CARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AMERIGROUP COMM CARE|MANAGED MEDICAID] standard_charge|[payer_AMERIVANTAGE MCR|MANAGED MEDICARE] standard_charge|[payer_AMERIVANTAGE MCR|MANAGED MEDICARE] |percent standard_charge|[payer_AMERIVANTAGE MCR|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AMERIVANTAGE MCR|MANAGED MEDICARE] standard_charge|[payer_ANTHEM BCBS|BLUE CROSS] standard_charge|[payer_ANTHEM BCBS|BLUE CROSS] |percent standard_charge|[payer_ANTHEM BCBS|BLUE CROSS] |contracting_method additional_payer_notes |[payer_ANTHEM BCBS|BLUE CROSS] standard_charge|[payer_ANTHEM FLEX HOUR SUP PLAN|COMMERCIAL] standard_charge|[payer_ANTHEM FLEX HOUR SUP PLAN|COMMERCIAL] |percent standard_charge|[payer_ANTHEM FLEX HOUR SUP PLAN|COMMERCIAL] |contracting_method additional_payer_notes |[payer_ANTHEM FLEX HOUR SUP PLAN|COMMERCIAL] standard_charge|[payer_APS HEALTHCARE GA DOBH|HMO/PPO] standard_charge|[payer_APS HEALTHCARE GA DOBH|HMO/PPO] |percent standard_charge|[payer_APS HEALTHCARE GA DOBH|HMO/PPO] |contracting_method additional_payer_notes |[payer_APS HEALTHCARE GA DOBH|HMO/PPO] standard_charge|[payer_ASPEN STM IBS ADMIN ZELIS|COMMERCIAL] standard_charge|[payer_ASPEN STM IBS ADMIN ZELIS|COMMERCIAL] |percent standard_charge|[payer_ASPEN STM IBS ADMIN ZELIS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_ASPEN STM IBS ADMIN ZELIS|COMMERCIAL] standard_charge|[payer_BAS|COMMERCIAL] standard_charge|[payer_BAS|COMMERCIAL] |percent standard_charge|[payer_BAS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_BAS|COMMERCIAL] standard_charge|[payer_BAS|HMO/PPO] standard_charge|[payer_BAS|HMO/PPO] |percent standard_charge|[payer_BAS|HMO/PPO] |contracting_method additional_payer_notes |[payer_BAS|HMO/PPO] standard_charge|[payer_BCBS MEDICARE MCR|MANAGED MEDICARE] standard_charge|[payer_BCBS MEDICARE MCR|MANAGED MEDICARE] |percent standard_charge|[payer_BCBS MEDICARE MCR|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BCBS MEDICARE MCR|MANAGED MEDICARE] standard_charge|[payer_BEACON HEALTH CARE MCR|MANAGED MEDICARE] standard_charge|[payer_BEACON HEALTH CARE MCR|MANAGED MEDICARE] |percent standard_charge|[payer_BEACON HEALTH CARE MCR|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BEACON HEALTH CARE MCR|MANAGED MEDICARE] 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_BEHAVIORAL HEALTH SYSTEMS|COMMERCIAL] standard_charge|[payer_BEHAVIORAL HEALTH SYSTEMS|COMMERCIAL] |percent standard_charge|[payer_BEHAVIORAL HEALTH SYSTEMS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_BEHAVIORAL HEALTH SYSTEMS|COMMERCIAL] standard_charge|[payer_BIND/UNITED HEALTHCARE|HMO/PPO] standard_charge|[payer_BIND/UNITED HEALTHCARE|HMO/PPO] |percent standard_charge|[payer_BIND/UNITED HEALTHCARE|HMO/PPO] |contracting_method additional_payer_notes |[payer_BIND/UNITED HEALTHCARE|HMO/PPO] standard_charge|[payer_BRIGHT HEALTHCARE|HMO/PPO] standard_charge|[payer_BRIGHT HEALTHCARE|HMO/PPO] |percent standard_charge|[payer_BRIGHT HEALTHCARE|HMO/PPO] |contracting_method additional_payer_notes |[payer_BRIGHT HEALTHCARE|HMO/PPO] standard_charge|[payer_CARE NETWORK|COMMERCIAL] standard_charge|[payer_CARE NETWORK|COMMERCIAL] |percent standard_charge|[payer_CARE NETWORK|COMMERCIAL] |contracting_method additional_payer_notes |[payer_CARE NETWORK|COMMERCIAL] standard_charge|[payer_CARESOURCE|MANAGED MEDICAID] standard_charge|[payer_CARESOURCE|MANAGED MEDICAID] |percent standard_charge|[payer_CARESOURCE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_CARESOURCE|MANAGED MEDICAID] standard_charge|[payer_CARESOURCE MARKETPLACE|HMO/PPO] standard_charge|[payer_CARESOURCE MARKETPLACE|HMO/PPO] |percent standard_charge|[payer_CARESOURCE MARKETPLACE|HMO/PPO] |contracting_method additional_payer_notes |[payer_CARESOURCE MARKETPLACE|HMO/PPO] standard_charge|[payer_CARESOURCE MARTKETPLACE|HMO/PPO] standard_charge|[payer_CARESOURCE MARTKETPLACE|HMO/PPO] |percent standard_charge|[payer_CARESOURCE MARTKETPLACE|HMO/PPO] |contracting_method additional_payer_notes |[payer_CARESOURCE MARTKETPLACE|HMO/PPO] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |percent standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CIGNA|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 GWH|HMO/PPO] standard_charge|[payer_CIGNA GWH|HMO/PPO] |percent standard_charge|[payer_CIGNA GWH|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA GWH|HMO/PPO] standard_charge|[payer_CIGNA HEALTH SPRING MCR|MANAGED MEDICARE] standard_charge|[payer_CIGNA HEALTH SPRING MCR|MANAGED MEDICARE] |percent standard_charge|[payer_CIGNA HEALTH SPRING MCR|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CIGNA HEALTH SPRING MCR|MANAGED MEDICARE] standard_charge|[payer_COMMERCIAL INS|COMMERCIAL] standard_charge|[payer_COMMERCIAL INS|COMMERCIAL] |percent standard_charge|[payer_COMMERCIAL INS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_COMMERCIAL INS|COMMERCIAL] standard_charge|[payer_COMPSYCH CORPORATION|HMO/PPO] standard_charge|[payer_COMPSYCH CORPORATION|HMO/PPO] |percent standard_charge|[payer_COMPSYCH CORPORATION|HMO/PPO] |contracting_method additional_payer_notes |[payer_COMPSYCH CORPORATION|HMO/PPO] standard_charge|[payer_CORE ADMINISTRATIVE SVCS|COMMERCIAL] standard_charge|[payer_CORE ADMINISTRATIVE SVCS|COMMERCIAL] |percent standard_charge|[payer_CORE ADMINISTRATIVE SVCS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_CORE ADMINISTRATIVE SVCS|COMMERCIAL] standard_charge|[payer_CORESOURCE GULFSTREAM|COMMERCIAL] standard_charge|[payer_CORESOURCE GULFSTREAM|COMMERCIAL] |percent standard_charge|[payer_CORESOURCE GULFSTREAM|COMMERCIAL] |contracting_method additional_payer_notes |[payer_CORESOURCE GULFSTREAM|COMMERCIAL] standard_charge|[payer_COVENTRY|COMMERCIAL] standard_charge|[payer_COVENTRY|COMMERCIAL] |percent standard_charge|[payer_COVENTRY|COMMERCIAL] |contracting_method additional_payer_notes |[payer_COVENTRY|COMMERCIAL] standard_charge|[payer_DFCS RICHMOND COUNTY|MANAGED MEDICAID] standard_charge|[payer_DFCS RICHMOND COUNTY|MANAGED MEDICAID] |percent standard_charge|[payer_DFCS RICHMOND COUNTY|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_DFCS RICHMOND COUNTY|MANAGED MEDICAID] 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_EMP BEN MGMT SVC|COMMERCIAL] standard_charge|[payer_EMP BEN MGMT SVC|COMMERCIAL] |percent standard_charge|[payer_EMP BEN MGMT SVC|COMMERCIAL] |contracting_method additional_payer_notes |[payer_EMP BEN MGMT SVC|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_GA VICTIMS ADVOCACY|COMMERCIAL] standard_charge|[payer_GA VICTIMS ADVOCACY|COMMERCIAL] |percent standard_charge|[payer_GA VICTIMS ADVOCACY|COMMERCIAL] |contracting_method additional_payer_notes |[payer_GA VICTIMS ADVOCACY|COMMERCIAL] standard_charge|[payer_GEHA|HMO/PPO] standard_charge|[payer_GEHA|HMO/PPO] |percent standard_charge|[payer_GEHA|HMO/PPO] |contracting_method additional_payer_notes |[payer_GEHA|HMO/PPO] standard_charge|[payer_GMR HEALTHCARE|COMMERCIAL] standard_charge|[payer_GMR HEALTHCARE|COMMERCIAL] |percent standard_charge|[payer_GMR HEALTHCARE|COMMERCIAL] |contracting_method additional_payer_notes |[payer_GMR HEALTHCARE|COMMERCIAL] standard_charge|[payer_GPA (GA PARTNERS ADMIN)|COMMERCIAL] standard_charge|[payer_GPA (GA PARTNERS ADMIN)|COMMERCIAL] |percent standard_charge|[payer_GPA (GA PARTNERS ADMIN)|COMMERCIAL] |contracting_method additional_payer_notes |[payer_GPA (GA PARTNERS ADMIN)|COMMERCIAL] standard_charge|[payer_HAP|HMO/PPO] standard_charge|[payer_HAP|HMO/PPO] |percent standard_charge|[payer_HAP|HMO/PPO] |contracting_method additional_payer_notes |[payer_HAP|HMO/PPO] "standard_charge|[payer_HEALTH PLANS, INC|COMMERCIAL]" "standard_charge|[payer_HEALTH PLANS, INC|COMMERCIAL] |percent" "standard_charge|[payer_HEALTH PLANS, INC|COMMERCIAL] |contracting_method" "additional_payer_notes |[payer_HEALTH PLANS, INC|COMMERCIAL]" standard_charge|[payer_HEALTHGRAM|HMO/PPO] standard_charge|[payer_HEALTHGRAM|HMO/PPO] |percent standard_charge|[payer_HEALTHGRAM|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTHGRAM|HMO/PPO] standard_charge|[payer_HEALTHSCOPE BENEFITS|HMO/PPO] standard_charge|[payer_HEALTHSCOPE BENEFITS|HMO/PPO] |percent standard_charge|[payer_HEALTHSCOPE BENEFITS|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTHSCOPE BENEFITS|HMO/PPO] standard_charge|[payer_HEALTHSMART CLAIMS|COMMERCIAL] standard_charge|[payer_HEALTHSMART CLAIMS|COMMERCIAL] |percent standard_charge|[payer_HEALTHSMART CLAIMS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HEALTHSMART CLAIMS|COMMERCIAL] standard_charge|[payer_HUMANA|COMMERCIAL] standard_charge|[payer_HUMANA|COMMERCIAL] |percent standard_charge|[payer_HUMANA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HUMANA|COMMERCIAL] 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 MEDICARE HMO|MANAGED MEDICARE] standard_charge|[payer_HUMANA MEDICARE HMO|MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA MEDICARE HMO|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA MEDICARE HMO|MANAGED MEDICARE] standard_charge|[payer_IMAGINE 360|COMMERCIAL] standard_charge|[payer_IMAGINE 360|COMMERCIAL] |percent standard_charge|[payer_IMAGINE 360|COMMERCIAL] |contracting_method additional_payer_notes |[payer_IMAGINE 360|COMMERCIAL] standard_charge|[payer_KAISER PERMANENTE|HMO/PPO] standard_charge|[payer_KAISER PERMANENTE|HMO/PPO] |percent standard_charge|[payer_KAISER PERMANENTE|HMO/PPO] |contracting_method additional_payer_notes |[payer_KAISER PERMANENTE|HMO/PPO] standard_charge|[payer_KAISER PERMANENTE OF GA|HMO/PPO] standard_charge|[payer_KAISER PERMANENTE OF GA|HMO/PPO] |percent standard_charge|[payer_KAISER PERMANENTE OF GA|HMO/PPO] |contracting_method additional_payer_notes |[payer_KAISER PERMANENTE OF GA|HMO/PPO] standard_charge|[payer_LINECO CONSTRUCTION BEN|COMMERCIAL] standard_charge|[payer_LINECO CONSTRUCTION BEN|COMMERCIAL] |percent standard_charge|[payer_LINECO CONSTRUCTION BEN|COMMERCIAL] |contracting_method additional_payer_notes |[payer_LINECO CONSTRUCTION BEN|COMMERCIAL] standard_charge|[payer_MAESTRO HEALTH|COMMERCIAL] standard_charge|[payer_MAESTRO HEALTH|COMMERCIAL] |percent standard_charge|[payer_MAESTRO HEALTH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MAESTRO HEALTH|COMMERCIAL] standard_charge|[payer_MAGELLAN|BLUE CROSS] standard_charge|[payer_MAGELLAN|BLUE CROSS] |percent standard_charge|[payer_MAGELLAN|BLUE CROSS] |contracting_method additional_payer_notes |[payer_MAGELLAN|BLUE CROSS] standard_charge|[payer_MAGELLAN/LOWES|COMMERCIAL] standard_charge|[payer_MAGELLAN/LOWES|COMMERCIAL] |percent standard_charge|[payer_MAGELLAN/LOWES|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MAGELLAN/LOWES|COMMERCIAL] standard_charge|[payer_MAYO CLINIC HLT SOL|COMMERCIAL] standard_charge|[payer_MAYO CLINIC HLT SOL|COMMERCIAL] |percent standard_charge|[payer_MAYO CLINIC HLT SOL|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MAYO CLINIC HLT SOL|COMMERCIAL] standard_charge|[payer_MEDCOST BENEFITS|HMO/PPO] standard_charge|[payer_MEDCOST BENEFITS|HMO/PPO] |percent standard_charge|[payer_MEDCOST BENEFITS|HMO/PPO] |contracting_method additional_payer_notes |[payer_MEDCOST BENEFITS|HMO/PPO] standard_charge|[payer_MEDICAID ONLY / CHARITY|SELF PAY CHARITY] standard_charge|[payer_MEDICAID ONLY / CHARITY|SELF PAY CHARITY] |percent standard_charge|[payer_MEDICAID ONLY / CHARITY|SELF PAY CHARITY] |contracting_method additional_payer_notes |[payer_MEDICAID ONLY / CHARITY|SELF PAY CHARITY] 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_MERITAIN HEALTH|COMMERCIAL] standard_charge|[payer_MERITAIN HEALTH|COMMERCIAL] |percent standard_charge|[payer_MERITAIN HEALTH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MERITAIN HEALTH|COMMERCIAL] standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] |percent standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_MERITAIN HEALTH|HMO/PPO] standard_charge|[payer_MHNET CLAIMS|HMO/PPO] standard_charge|[payer_MHNET CLAIMS|HMO/PPO] |percent standard_charge|[payer_MHNET CLAIMS|HMO/PPO] |contracting_method additional_payer_notes |[payer_MHNET CLAIMS|HMO/PPO] standard_charge|[payer_MUTUAL OF OMAHA - PLAN G|COMMERCIAL] standard_charge|[payer_MUTUAL OF OMAHA - PLAN G|COMMERCIAL] |percent standard_charge|[payer_MUTUAL OF OMAHA - PLAN G|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MUTUAL OF OMAHA - PLAN G|COMMERCIAL] standard_charge|[payer_NOVANET|COMMERCIAL] standard_charge|[payer_NOVANET|COMMERCIAL] |percent standard_charge|[payer_NOVANET|COMMERCIAL] |contracting_method additional_payer_notes |[payer_NOVANET|COMMERCIAL] standard_charge|[payer_OPTUM UBH|HMO/PPO] standard_charge|[payer_OPTUM UBH|HMO/PPO] |percent standard_charge|[payer_OPTUM UBH|HMO/PPO] |contracting_method additional_payer_notes |[payer_OPTUM UBH|HMO/PPO] standard_charge|[payer_PEACH STATE HEALTH PLAN|MANAGED MEDICAID] standard_charge|[payer_PEACH STATE HEALTH PLAN|MANAGED MEDICAID] |percent standard_charge|[payer_PEACH STATE HEALTH PLAN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_PEACH STATE HEALTH PLAN|MANAGED MEDICAID] standard_charge|[payer_RESOURCE ONE|COMMERCIAL] standard_charge|[payer_RESOURCE ONE|COMMERCIAL] |percent standard_charge|[payer_RESOURCE ONE|COMMERCIAL] |contracting_method additional_payer_notes |[payer_RESOURCE ONE|COMMERCIAL] standard_charge|[payer_SECURE HEALTH PLANS OF GA|COMMERCIAL] standard_charge|[payer_SECURE HEALTH PLANS OF GA|COMMERCIAL] |percent standard_charge|[payer_SECURE HEALTH PLANS OF GA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_SECURE HEALTH PLANS OF GA|COMMERCIAL] standard_charge|[payer_SECURE HEALTH PLANS OF GA|HMO/PPO] standard_charge|[payer_SECURE HEALTH PLANS OF GA|HMO/PPO] |percent standard_charge|[payer_SECURE HEALTH PLANS OF GA|HMO/PPO] |contracting_method additional_payer_notes |[payer_SECURE HEALTH PLANS OF GA|HMO/PPO] standard_charge|[payer_SECURE HORIZONS|MANAGED MEDICARE] standard_charge|[payer_SECURE HORIZONS|MANAGED MEDICARE] |percent standard_charge|[payer_SECURE HORIZONS|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_SECURE HORIZONS|MANAGED MEDICARE] standard_charge|[payer_SOMOS IPA LLC|MANAGED MEDICAID] standard_charge|[payer_SOMOS IPA LLC|MANAGED MEDICAID] |percent standard_charge|[payer_SOMOS IPA LLC|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SOMOS IPA LLC|MANAGED MEDICAID] standard_charge|[payer_SURESTPO|HMO/PPO] standard_charge|[payer_SURESTPO|HMO/PPO] |percent standard_charge|[payer_SURESTPO|HMO/PPO] |contracting_method additional_payer_notes |[payer_SURESTPO|HMO/PPO] standard_charge|[payer_TAYLOR BENEFIT RESOURCE|HMO/PPO] standard_charge|[payer_TAYLOR BENEFIT RESOURCE|HMO/PPO] |percent standard_charge|[payer_TAYLOR BENEFIT RESOURCE|HMO/PPO] |contracting_method additional_payer_notes |[payer_TAYLOR BENEFIT RESOURCE|HMO/PPO] standard_charge|[payer_TLC BENEFIT SOLUTIONS INC|COMMERCIAL] standard_charge|[payer_TLC BENEFIT SOLUTIONS INC|COMMERCIAL] |percent standard_charge|[payer_TLC BENEFIT SOLUTIONS INC|COMMERCIAL] |contracting_method additional_payer_notes |[payer_TLC BENEFIT SOLUTIONS INC|COMMERCIAL] standard_charge|[payer_TLC BENEFIT SOLUTIONS INC|HMO/PPO] standard_charge|[payer_TLC BENEFIT SOLUTIONS INC|HMO/PPO] |percent standard_charge|[payer_TLC BENEFIT SOLUTIONS INC|HMO/PPO] |contracting_method additional_payer_notes |[payer_TLC BENEFIT SOLUTIONS INC|HMO/PPO] standard_charge|[payer_TRICARE EAST|TRICARE] standard_charge|[payer_TRICARE EAST|TRICARE] |percent standard_charge|[payer_TRICARE EAST|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE EAST|TRICARE] standard_charge|[payer_TRICARE 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_TRUSTMARK HEALTH BENEFITS|BLUE CROSS] standard_charge|[payer_TRUSTMARK HEALTH BENEFITS|BLUE CROSS] |percent standard_charge|[payer_TRUSTMARK HEALTH BENEFITS|BLUE CROSS] |contracting_method additional_payer_notes |[payer_TRUSTMARK HEALTH BENEFITS|BLUE CROSS] standard_charge|[payer_TRUSTMARK HEALTH BENEFITS|HMO/PPO] standard_charge|[payer_TRUSTMARK HEALTH BENEFITS|HMO/PPO] |percent standard_charge|[payer_TRUSTMARK HEALTH BENEFITS|HMO/PPO] |contracting_method additional_payer_notes |[payer_TRUSTMARK HEALTH BENEFITS|HMO/PPO] standard_charge|[payer_UHC MEDICAID|MANAGED MEDICAID] standard_charge|[payer_UHC MEDICAID|MANAGED MEDICAID] |percent standard_charge|[payer_UHC MEDICAID|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_UHC MEDICAID|MANAGED MEDICAID] standard_charge|[payer_UHC STATE HEALTH PLAN|HMO/PPO] standard_charge|[payer_UHC STATE HEALTH PLAN|HMO/PPO] |percent standard_charge|[payer_UHC STATE HEALTH PLAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC STATE HEALTH PLAN|HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURCES|HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURCES|HMO/PPO] |percent standard_charge|[payer_UHC STUDENT RESOURCES|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC STUDENT RESOURCES|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO] |percent standard_charge|[payer_UMR|HMO/PPO] |contracting_method additional_payer_notes |[payer_UMR|HMO/PPO] standard_charge|[payer_UMR CITY OF VALDOSTA|HMO/PPO] standard_charge|[payer_UMR CITY OF VALDOSTA|HMO/PPO] |percent standard_charge|[payer_UMR CITY OF VALDOSTA|HMO/PPO] |contracting_method additional_payer_notes |[payer_UMR CITY OF VALDOSTA|HMO/PPO] standard_charge|[payer_UNITEDHC MCR SOLUTIONS|MANAGED MEDICARE] standard_charge|[payer_UNITEDHC MCR SOLUTIONS|MANAGED MEDICARE] |percent standard_charge|[payer_UNITEDHC MCR SOLUTIONS|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UNITEDHC MCR SOLUTIONS|MANAGED MEDICARE] standard_charge|[payer_VACCN OPTUM|VETERANS ADMIN] standard_charge|[payer_VACCN OPTUM|VETERANS ADMIN] |percent standard_charge|[payer_VACCN OPTUM|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_VACCN OPTUM|VETERANS ADMIN] standard_charge|[payer_VALUE OPTIONS|COMMERCIAL] standard_charge|[payer_VALUE OPTIONS|COMMERCIAL] |percent standard_charge|[payer_VALUE OPTIONS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_VALUE OPTIONS|COMMERCIAL] standard_charge|[payer_WELLCARE MEDICAID CLAIMS|MANAGED MEDICAID] standard_charge|[payer_WELLCARE MEDICAID CLAIMS|MANAGED MEDICAID] |percent standard_charge|[payer_WELLCARE MEDICAID CLAIMS|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_WELLCARE MEDICAID CLAIMS|MANAGED MEDICAID] standard_charge|[payer_WELLCARE MEDICARE OF GA|MANAGED MEDICARE] standard_charge|[payer_WELLCARE MEDICARE OF GA|MANAGED MEDICARE] |percent standard_charge|[payer_WELLCARE MEDICARE OF GA|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_WELLCARE MEDICARE OF GA|MANAGED MEDICARE] ROOM AND BOARD PSYCH ADULT ME 124 RC facility inpatient 2000.00 600 600.00 2000 762 per diem 750 per diem 880 per diem 880 per diem 976 per diem 1800 per diem 750 per diem 931 per diem 750 per diem 750 per diem 760 per diem 931 per diem 2000 per diem 840 per diem 750 per diem 750 per diem 750 per diem 815 per diem 675 per diem 921 per diem 1800 per diem 750 per diem 760 per diem 760 per diem 833 per diem 833 per diem 750 per diem 815 per diem 750 per diem 750 per diem 675 per diem 600 per diem 2000 per diem 750 per diem 750 per diem 800 per diem 820 per diem 931 per diem 820 per diem 833 per diem 2000 per diem 833 per diem 820 per diem 1800 per diem 812 per diem 1800 per diem 750 per diem 750 per diem 750 per diem 750 per diem 1028 per diem 1028 per diem 750 per diem 750 per diem 600 per diem 850 per diem 675 per diem 750 per diem 750 per diem 976 per diem 801 per diem 750 per diem 750 per diem 762 per diem 931 per diem 976 per diem 750 per diem 800 per diem 892.5 per diem 834.7 per diem 931 per diem 778 per diem 976 per diem 976 per diem 921 per diem 921 per diem 800 per diem 815 per diem 658 per diem 658 per diem ROOM AND BOARD PSYCH GEN 124 RC facility inpatient 2000.00 600 600.00 2000 762 per diem 750 per diem 880 per diem 880 per diem 976 per diem 1800 per diem 750 per diem 931 per diem 750 per diem 750 per diem 760 per diem 931 per diem 2000 per diem 840 per diem 750 per diem 750 per diem 750 per diem 815 per diem 675 per diem 921 per diem 1800 per diem 750 per diem 760 per diem 760 per diem 833 per diem 833 per diem 750 per diem 815 per diem 750 per diem 750 per diem 675 per diem 600 per diem 2000 per diem 750 per diem 750 per diem 800 per diem 820 per diem 931 per diem 820 per diem 833 per diem 2000 per diem 833 per diem 820 per diem 1800 per diem 812 per diem 1800 per diem 750 per diem 750 per diem 750 per diem 750 per diem 1028 per diem 1028 per diem 750 per diem 750 per diem 600 per diem 850 per diem 675 per diem 750 per diem 750 per diem 976 per diem 801 per diem 750 per diem 750 per diem 762 per diem 931 per diem 976 per diem 750 per diem 800 per diem 892.5 per diem 834.7 per diem 931 per diem 778 per diem 976 per diem 976 per diem 921 per diem 921 per diem 800 per diem 815 per diem 658 per diem 658 per diem ROOM AND BOARD PSYCH PICU 124 RC facility inpatient 2000.00 600 600.00 2000 762 per diem 750 per diem 880 per diem 880 per diem 976 per diem 1800 per diem 750 per diem 931 per diem 750 per diem 750 per diem 760 per diem 931 per diem 2000 per diem 840 per diem 750 per diem 750 per diem 750 per diem 815 per diem 675 per diem 921 per diem 1800 per diem 750 per diem 760 per diem 760 per diem 833 per diem 833 per diem 750 per diem 815 per diem 750 per diem 750 per diem 675 per diem 600 per diem 2000 per diem 750 per diem 750 per diem 800 per diem 820 per diem 931 per diem 820 per diem 833 per diem 2000 per diem 833 per diem 820 per diem 1800 per diem 812 per diem 1800 per diem 750 per diem 750 per diem 750 per diem 750 per diem 1028 per diem 1028 per diem 750 per diem 750 per diem 600 per diem 850 per diem 675 per diem 750 per diem 750 per diem 976 per diem 801 per diem 750 per diem 750 per diem 762 per diem 931 per diem 976 per diem 750 per diem 800 per diem 892.5 per diem 834.7 per diem 931 per diem 778 per diem 976 per diem 976 per diem 921 per diem 921 per diem 800 per diem 815 per diem 658 per diem 658 per diem ROOM AND BOARD PSYCH REHAB 124 RC facility inpatient 2000.00 600 600.00 2000 762 per diem 750 per diem 880 per diem 880 per diem 976 per diem 1800 per diem 750 per diem 931 per diem 750 per diem 750 per diem 760 per diem 931 per diem 2000 per diem 840 per diem 750 per diem 750 per diem 750 per diem 815 per diem 675 per diem 921 per diem 1800 per diem 750 per diem 760 per diem 760 per diem 833 per diem 833 per diem 750 per diem 815 per diem 750 per diem 750 per diem 675 per diem 600 per diem 2000 per diem 750 per diem 750 per diem 800 per diem 820 per diem 931 per diem 820 per diem 833 per diem 2000 per diem 833 per diem 820 per diem 1800 per diem 812 per diem 1800 per diem 750 per diem 750 per diem 750 per diem 750 per diem 1028 per diem 1028 per diem 750 per diem 750 per diem 600 per diem 850 per diem 675 per diem 750 per diem 750 per diem 976 per diem 801 per diem 750 per diem 750 per diem 762 per diem 931 per diem 976 per diem 750 per diem 800 per diem 892.5 per diem 834.7 per diem 931 per diem 778 per diem 976 per diem 976 per diem 921 per diem 921 per diem 800 per diem 815 per diem 658 per diem 658 per diem INPATIENT 126 RC facility inpatient 2000.00 600 600.00 2000 704 per diem 750 per diem 880 per diem 880 per diem 1000 per diem 1800 per diem 750 per diem 931 per diem 750 per diem 750 per diem 760 per diem 931 per diem 2000 per diem 840 per diem 750 per diem 750 per diem 750 per diem 815 per diem 675 per diem 921 per diem 1800 per diem 750 per diem 760 per diem 760 per diem 833 per diem 833 per diem 750 per diem 750 per diem 750 per diem 675 per diem 600 per diem 2000 per diem 750 per diem 750 per diem 800 per diem 820 per diem 931 per diem 820 per diem 833 per diem 2000 per diem 833 per diem 820 per diem 1800 per diem 812 per diem 1800 per diem 750 per diem 750 per diem 750 per diem 750 per diem 1017 per diem 1017 per diem 750 per diem 750 per diem 600 per diem 850 per diem 675 per diem 750 per diem 750 per diem 1000 per diem 801 per diem 750 per diem 750 per diem 704 per diem 931 per diem 1000 per diem 750 per diem 800 per diem 892.5 per diem 834.7 per diem 931 per diem 1000 per diem 1000 per diem 921 per diem 921 per diem 840 per diem 815 per diem 658 per diem 658 per diem ROOM AND BOARD DETOX GEN 126 RC facility inpatient 2000.00 600 600.00 2000 704 per diem 750 per diem 880 per diem 880 per diem 1000 per diem 1800 per diem 750 per diem 931 per diem 750 per diem 750 per diem 760 per diem 931 per diem 2000 per diem 840 per diem 750 per diem 750 per diem 750 per diem 815 per diem 675 per diem 921 per diem 1800 per diem 750 per diem 760 per diem 760 per diem 833 per diem 833 per diem 750 per diem 750 per diem 750 per diem 675 per diem 600 per diem 2000 per diem 750 per diem 750 per diem 800 per diem 820 per diem 931 per diem 820 per diem 833 per diem 2000 per diem 833 per diem 820 per diem 1800 per diem 812 per diem 1800 per diem 750 per diem 750 per diem 750 per diem 750 per diem 1017 per diem 1017 per diem 750 per diem 750 per diem 600 per diem 850 per diem 675 per diem 750 per diem 750 per diem 1000 per diem 801 per diem 750 per diem 750 per diem 704 per diem 931 per diem 1000 per diem 750 per diem 800 per diem 892.5 per diem 834.7 per diem 931 per diem 1000 per diem 1000 per diem 921 per diem 921 per diem 840 per diem 815 per diem 658 per diem 658 per diem ROOM AND BOARD DETOX REHAB 126 RC facility inpatient 2000.00 600 600.00 2000 704 per diem 750 per diem 880 per diem 880 per diem 1000 per diem 1800 per diem 750 per diem 931 per diem 750 per diem 750 per diem 760 per diem 931 per diem 2000 per diem 840 per diem 750 per diem 750 per diem 750 per diem 815 per diem 675 per diem 921 per diem 1800 per diem 750 per diem 760 per diem 760 per diem 833 per diem 833 per diem 750 per diem 750 per diem 750 per diem 675 per diem 600 per diem 2000 per diem 750 per diem 750 per diem 800 per diem 820 per diem 931 per diem 820 per diem 833 per diem 2000 per diem 833 per diem 820 per diem 1800 per diem 812 per diem 1800 per diem 750 per diem 750 per diem 750 per diem 750 per diem 1017 per diem 1017 per diem 750 per diem 750 per diem 600 per diem 850 per diem 675 per diem 750 per diem 750 per diem 1000 per diem 801 per diem 750 per diem 750 per diem 704 per diem 931 per diem 1000 per diem 750 per diem 800 per diem 892.5 per diem 834.7 per diem 931 per diem 1000 per diem 1000 per diem 921 per diem 921 per diem 840 per diem 815 per diem 658 per diem 658 per diem ROOM AND BOARD REHAB 128 RC facility inpatient 2000.00 600 600.00 2000 704 per diem 750 per diem 880 per diem 880 per diem 976 per diem 750 per diem 931 per diem 750 per diem 750 per diem 931 per diem 2000 per diem 840 per diem 750 per diem 750 per diem 750 per diem 815 per diem 675 per diem 921 per diem 750 per diem 760 per diem 760 per diem 833 per diem 833 per diem 750 per diem 750 per diem 750 per diem 675 per diem 600 per diem 2000 per diem 750 per diem 750 per diem 800 per diem 820 per diem 931 per diem 820 per diem 833 per diem 2000 per diem 833 per diem 820 per diem 1800 per diem 812 per diem 750 per diem 750 per diem 750 per diem 750 per diem 1028 per diem 1028 per diem 750 per diem 750 per diem 600 per diem 850 per diem 675 per diem 750 per diem 750 per diem 976 per diem 750 per diem 750 per diem 704 per diem 931 per diem 976 per diem 750 per diem 800 per diem 892.5 per diem 834.7 per diem 931 per diem 976 per diem 976 per diem 921 per diem 921 per diem 800 per diem 815 per diem 658 per diem 658 per diem DISCHARGE CONSULT 513 RC facility inpatient 100.00 0 55.00 85 55 per diem 55 per diem 80 per diem 80 per diem 80 per diem 55 per diem 85 per diem 85 per diem INTENSIVE OUTPATIENT PROGRAM ADOLES PROGRAM 905 RC facility outpatient 500.00 130.52 130.52 400 254 per diem 245 per diem 234 per diem 245 per diem 225 per diem 254 per diem 182.44 per diem 189 per diem 202.68 per diem 225 per diem 400 per diem 200.57 per diem 254 per diem 175 per diem 175 per diem 130.52 per diem 259 per diem 259 per diem 230 per diem 245 per diem 245 per diem 234 per diem 225 per diem 217 per diem 202.68 per diem 316 per diem 202.7 per diem 180 per diem 180 per diem 269 per diem 303 per diem 225 per diem 197.64 per diem 245 per diem 269 per diem 269 per diem 254 per diem 254 per diem 265 per diem 200 per diem 200 per diem INTENSIVE OUTPATIENT PROGRAM ADULT PROGRAM 905 RC facility outpatient 500.00 130.52 130.52 400 254 per diem 245 per diem 234 per diem 245 per diem 225 per diem 254 per diem 182.44 per diem 189 per diem 202.68 per diem 225 per diem 400 per diem 200.57 per diem 254 per diem 175 per diem 175 per diem 130.52 per diem 259 per diem 259 per diem 230 per diem 245 per diem 245 per diem 234 per diem 225 per diem 217 per diem 202.68 per diem 316 per diem 202.7 per diem 180 per diem 180 per diem 269 per diem 303 per diem 225 per diem 197.64 per diem 245 per diem 269 per diem 269 per diem 254 per diem 254 per diem 265 per diem 200 per diem 200 per diem INTENSIVE OUTPATIENT PROGRAM ADULT TELEMED 905 RC facility outpatient 500.00 130.52 130.52 400 254 per diem 245 per diem 234 per diem 245 per diem 225 per diem 254 per diem 182.44 per diem 189 per diem 202.68 per diem 225 per diem 400 per diem 200.57 per diem 254 per diem 175 per diem 175 per diem 130.52 per diem 259 per diem 259 per diem 230 per diem 245 per diem 245 per diem 234 per diem 225 per diem 217 per diem 202.68 per diem 316 per diem 202.7 per diem 180 per diem 180 per diem 269 per diem 303 per diem 225 per diem 197.64 per diem 245 per diem 269 per diem 269 per diem 254 per diem 254 per diem 265 per diem 200 per diem 200 per diem INTENSIVE OUTPATIENT PROGRAM CD PROG 906 RC facility outpatient 500.00 130.52 130.52 400 254 per diem 245 per diem 234 per diem 245 per diem 225 per diem 254 per diem 182.44 per diem 189 per diem 202.68 per diem 225 per diem 400 per diem 200.57 per diem 175 per diem 175 per diem 130.52 per diem 259 per diem 259 per diem 180 per diem 245 per diem 234 per diem 225 per diem 217 per diem 202.68 per diem 316 per diem 202.7 per diem 180 per diem 180 per diem 269 per diem 303 per diem 225 per diem 245 per diem 269 per diem 269 per diem 254 per diem 254 per diem 265 per diem 200 per diem 181 per diem PARTIAL HOSPITAL PROGRAM ADLT TELEMED 912 RC facility outpatient 700.00 227.06 211.64 609 497 per diem 470 per diem 451 per diem 470 per diem 469 per diem 497 per diem 211.64 per diem 347 per diem 235.15 per diem 469 per diem 600 per diem 417.05 per diem 490 per diem 300 per diem 300 per diem 227.06 per diem 450 per diem 450 per diem 500 per diem 500 per diem 451 per diem 469 per diem 325 per diem 235.15 per diem 609 per diem 235.15 per diem 300 per diem 300 per diem 490 per diem 465 per diem 420 per diem 425 per diem 229.28 per diem 217.54 per diem 470 per diem 490 per diem 490 per diem 490 per diem 490 per diem 497 per diem 227.06 per diem 425 per diem 333 per diem 333 per diem PARTIAL HOSPITAL PROGRAM ADOLES PROGRAM 912 RC facility outpatient 700.00 227.06 211.64 609 497 per diem 470 per diem 451 per diem 470 per diem 469 per diem 497 per diem 211.64 per diem 347 per diem 235.15 per diem 469 per diem 600 per diem 417.05 per diem 490 per diem 300 per diem 300 per diem 227.06 per diem 450 per diem 450 per diem 500 per diem 500 per diem 451 per diem 469 per diem 325 per diem 235.15 per diem 609 per diem 235.15 per diem 300 per diem 300 per diem 490 per diem 465 per diem 420 per diem 425 per diem 229.28 per diem 217.54 per diem 470 per diem 490 per diem 490 per diem 490 per diem 490 per diem 497 per diem 227.06 per diem 425 per diem 333 per diem 333 per diem PARTIAL HOSPITAL PROGRAM TRCRE ADOL PSED1 912 RC facility outpatient 700.00 227.06 211.64 609 497 per diem 470 per diem 451 per diem 470 per diem 469 per diem 497 per diem 211.64 per diem 347 per diem 235.15 per diem 469 per diem 600 per diem 417.05 per diem 490 per diem 300 per diem 300 per diem 227.06 per diem 450 per diem 450 per diem 500 per diem 500 per diem 451 per diem 469 per diem 325 per diem 235.15 per diem 609 per diem 235.15 per diem 300 per diem 300 per diem 490 per diem 465 per diem 420 per diem 425 per diem 229.28 per diem 217.54 per diem 470 per diem 490 per diem 490 per diem 490 per diem 490 per diem 497 per diem 227.06 per diem 425 per diem 333 per diem 333 per diem IND THERAPY 30 MIN 914 RC facility outpatient 245.00 0 58.00 235.15 84.29 per diem 84.29 per diem 235.15 per diem 235.15 per diem 84.29 per diem 58 per diem IND THERAPY 60 MIN 914 RC facility outpatient 295.00 0 58.00 235.15 84.29 per diem 84.29 per diem 235.15 per diem 235.15 per diem 84.29 per diem 58 per diem INTENSIVE OUTPATIENT PROGRAM PROC GRP 1 CD 915 RC facility outpatient 175.00 600 187.58 600 470 per diem 211.64 per diem 235.15 per diem 417.05 per diem 227.06 per diem 230.82 per diem 325 per diem 235.15 per diem 600 per diem 235.15 per diem 229.28 per diem 187.58 per diem 227.06 per diem 333 per diem INTENSIVE OUTPATIENT PROGRAM PROC GRP 1 PSYC 915 RC facility outpatient 175.00 600 187.58 600 470 per diem 211.64 per diem 235.15 per diem 417.05 per diem 227.06 per diem 230.82 per diem 325 per diem 235.15 per diem 600 per diem 235.15 per diem 229.28 per diem 187.58 per diem 227.06 per diem 333 per diem