"hospital_Southwestern Childrens Health Services, Inc. " last_updated_ 2023-12-31 version_1 "hospital_Chandler, Arizona" hospital_address 2190 N Grace Boulevard license_SH6172 | AZ "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded in this machine-readable file is true, accurate, and complete as of the date indicated in this file" description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AARP MDCR SUPP|COMMERCIAL] standard_charge|[payer_AARP MDCR SUPP|COMMERCIAL] |percent standard_charge|[payer_AARP MDCR SUPP|COMMERCIAL] |contracting_method additional_payer_notes |[payer_AARP MDCR SUPP|COMMERCIAL] 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_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 BANNER|HMO/PPO] standard_charge|[payer_AETNA BANNER|HMO/PPO] |percent standard_charge|[payer_AETNA BANNER|HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA BANNER|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_AHCCCS APACHE|MEDICAID ] standard_charge|[payer_AHCCCS APACHE|MEDICAID ] |percent standard_charge|[payer_AHCCCS APACHE|MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS APACHE|MEDICAID ] standard_charge|[payer_AHCCCS FED EMERG|MEDICAID ] standard_charge|[payer_AHCCCS FED EMERG|MEDICAID ] |percent standard_charge|[payer_AHCCCS FED EMERG|MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS FED EMERG|MEDICAID ] standard_charge|[payer_AHCCCS FFS|MEDICAID ] standard_charge|[payer_AHCCCS FFS|MEDICAID ] |percent standard_charge|[payer_AHCCCS FFS|MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS FFS|MEDICAID ] standard_charge|[payer_AHCCCS GILA RIVER|MEDICAID ] standard_charge|[payer_AHCCCS GILA RIVER|MEDICAID ] |percent standard_charge|[payer_AHCCCS GILA RIVER|MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS GILA RIVER|MEDICAID ] standard_charge|[payer_AHCCCS IHS|MEDICAID ] standard_charge|[payer_AHCCCS IHS|MEDICAID ] |percent standard_charge|[payer_AHCCCS IHS|MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS IHS|MEDICAID ] standard_charge|[payer_AHCCCS NAVAJO NATION|MEDICAID ] standard_charge|[payer_AHCCCS NAVAJO NATION|MEDICAID ] |percent standard_charge|[payer_AHCCCS NAVAJO NATION|MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS NAVAJO NATION|MEDICAID ] standard_charge|[payer_AHCCCS PASCUA YAQUI|MEDICAID ] standard_charge|[payer_AHCCCS PASCUA YAQUI|MEDICAID ] |percent standard_charge|[payer_AHCCCS PASCUA YAQUI|MEDICAID ] |contracting_method additional_payer_notes |[payer_AHCCCS PASCUA YAQUI|MEDICAID ] standard_charge|[payer_ALL SAVERS|HMO/PPO] standard_charge|[payer_ALL SAVERS|HMO/PPO] |percent standard_charge|[payer_ALL SAVERS|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALL SAVERS|HMO/PPO] standard_charge|[payer_ALLIED BENEFITS SYSTEM|HMO/PPO] standard_charge|[payer_ALLIED BENEFITS SYSTEM|HMO/PPO] |percent standard_charge|[payer_ALLIED BENEFITS SYSTEM|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALLIED BENEFITS SYSTEM|HMO/PPO] standard_charge|[payer_ALLWELL MDCR ADV|MANAGED MEDICARE] standard_charge|[payer_ALLWELL MDCR ADV|MANAGED MEDICARE] |percent standard_charge|[payer_ALLWELL MDCR ADV|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_ALLWELL MDCR ADV|MANAGED MEDICARE] standard_charge|[payer_AMBETTER EXCHANGE|COMMERCIAL] standard_charge|[payer_AMBETTER EXCHANGE|COMMERCIAL] |percent standard_charge|[payer_AMBETTER EXCHANGE|COMMERCIAL] |contracting_method additional_payer_notes |[payer_AMBETTER EXCHANGE|COMMERCIAL] standard_charge|[payer_AOC APACHE COUNTY|LOCAL GOVT] standard_charge|[payer_AOC APACHE COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC APACHE COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC APACHE COUNTY|LOCAL GOVT] standard_charge|[payer_AOC COCHISE COUNTY|LOCAL GOVT] standard_charge|[payer_AOC COCHISE COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC COCHISE COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC COCHISE COUNTY|LOCAL GOVT] standard_charge|[payer_AOC COCONINO|LOCAL GOVT] standard_charge|[payer_AOC COCONINO|LOCAL GOVT] |percent standard_charge|[payer_AOC COCONINO|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC COCONINO|LOCAL GOVT] standard_charge|[payer_AOC GILA COUNTY|LOCAL GOVT] standard_charge|[payer_AOC GILA COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC GILA COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC GILA COUNTY|LOCAL GOVT] standard_charge|[payer_AOC GRAHAM COUNTY|LOCAL GOVT] standard_charge|[payer_AOC GRAHAM COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC GRAHAM COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC GRAHAM COUNTY|LOCAL GOVT] standard_charge|[payer_AOC GREENLEE COUNTY|LOCAL GOVT] standard_charge|[payer_AOC GREENLEE COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC GREENLEE COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC GREENLEE COUNTY|LOCAL GOVT] standard_charge|[payer_AOC MARICOPA JUVENILE|LOCAL GOVT] standard_charge|[payer_AOC MARICOPA JUVENILE|LOCAL GOVT] |percent standard_charge|[payer_AOC MARICOPA JUVENILE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC MARICOPA JUVENILE|LOCAL GOVT] standard_charge|[payer_AOC MOHAVE COUNTY|LOCAL GOVT] standard_charge|[payer_AOC MOHAVE COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC MOHAVE COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC MOHAVE COUNTY|LOCAL GOVT] standard_charge|[payer_AOC NAVAJO COUNTY|LOCAL GOVT] standard_charge|[payer_AOC NAVAJO COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC NAVAJO COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC NAVAJO COUNTY|LOCAL GOVT] standard_charge|[payer_AOC PIMA CTY JUVENILE|LOCAL GOVT] standard_charge|[payer_AOC PIMA CTY JUVENILE|LOCAL GOVT] |percent standard_charge|[payer_AOC PIMA CTY JUVENILE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC PIMA CTY JUVENILE|LOCAL GOVT] standard_charge|[payer_AOC PINAL CTY JUVENIL|LOCAL GOVT] standard_charge|[payer_AOC PINAL CTY JUVENIL|LOCAL GOVT] |percent standard_charge|[payer_AOC PINAL CTY JUVENIL|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC PINAL CTY JUVENIL|LOCAL GOVT] standard_charge|[payer_AOC SANTA CRUZ COUNTY|LOCAL GOVT] standard_charge|[payer_AOC SANTA CRUZ COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC SANTA CRUZ COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC SANTA CRUZ COUNTY|LOCAL GOVT] standard_charge|[payer_AOC YAVAPAI COUNTY|LOCAL GOVT] standard_charge|[payer_AOC YAVAPAI COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC YAVAPAI COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC YAVAPAI COUNTY|LOCAL GOVT] standard_charge|[payer_AOC YUMA COUNTY|LOCAL GOVT] standard_charge|[payer_AOC YUMA COUNTY|LOCAL GOVT] |percent standard_charge|[payer_AOC YUMA COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AOC YUMA COUNTY|LOCAL GOVT] standard_charge|[payer_ARIZONA COMPLETE HEALTH|MANAGED MEDICAID] standard_charge|[payer_ARIZONA COMPLETE HEALTH|MANAGED MEDICAID] |percent standard_charge|[payer_ARIZONA COMPLETE HEALTH|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_ARIZONA COMPLETE HEALTH|MANAGED MEDICAID] standard_charge|[payer_AZ FOUNDATION|COMMERCIAL] standard_charge|[payer_AZ FOUNDATION|COMMERCIAL] |percent standard_charge|[payer_AZ FOUNDATION|COMMERCIAL] |contracting_method additional_payer_notes |[payer_AZ FOUNDATION|COMMERCIAL] standard_charge|[payer_BCBS CORP HEALTH|BLUE CROSS] standard_charge|[payer_BCBS CORP HEALTH|BLUE CROSS] |percent standard_charge|[payer_BCBS CORP HEALTH|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS CORP HEALTH|BLUE CROSS] standard_charge|[payer_BCBS FEDERAL|BLUE CROSS] standard_charge|[payer_BCBS FEDERAL|BLUE CROSS] |percent standard_charge|[payer_BCBS FEDERAL|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS FEDERAL|BLUE CROSS] standard_charge|[payer_BCBS MEDICARE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_BCBS MEDICARE ADVANTAGE|MANAGED MEDICARE] |percent standard_charge|[payer_BCBS MEDICARE ADVANTAGE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BCBS MEDICARE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_BCBS OF AZ|BLUE CROSS] standard_charge|[payer_BCBS OF AZ|BLUE CROSS] |percent standard_charge|[payer_BCBS OF AZ|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OF AZ|BLUE CROSS] standard_charge|[payer_BCBS OOS|BLUE CROSS] standard_charge|[payer_BCBS OOS|BLUE CROSS] |percent standard_charge|[payer_BCBS OOS|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OOS|BLUE CROSS] 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_BNNR UNIV ADOL|MANAGED MEDICAID] standard_charge|[payer_BNNR UNIV ADOL|MANAGED MEDICAID] |percent standard_charge|[payer_BNNR UNIV ADOL|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BNNR UNIV ADOL|MANAGED MEDICAID] standard_charge|[payer_BNNR UNIV ADUL|MANAGED MEDICAID] standard_charge|[payer_BNNR UNIV ADUL|MANAGED MEDICAID] |percent standard_charge|[payer_BNNR UNIV ADUL|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BNNR UNIV ADUL|MANAGED MEDICAID] standard_charge|[payer_BOONE ADMINISTRATIVE SERV|HMO/PPO] standard_charge|[payer_BOONE ADMINISTRATIVE SERV|HMO/PPO] |percent standard_charge|[payer_BOONE ADMINISTRATIVE SERV|HMO/PPO] |contracting_method additional_payer_notes |[payer_BOONE ADMINISTRATIVE SERV|HMO/PPO] standard_charge|[payer_BRIGHT HEALTH|HMO/PPO] standard_charge|[payer_BRIGHT HEALTH|HMO/PPO] |percent standard_charge|[payer_BRIGHT HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_BRIGHT HEALTH|HMO/PPO] standard_charge|[payer_BRIGHT HEALTH MDCR ADV|MANAGED MEDICARE] standard_charge|[payer_BRIGHT HEALTH MDCR ADV|MANAGED MEDICARE] |percent standard_charge|[payer_BRIGHT HEALTH MDCR ADV|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BRIGHT HEALTH MDCR ADV|MANAGED MEDICARE] standard_charge|[payer_CARE FIRST|MANAGED MEDICAID] standard_charge|[payer_CARE FIRST|MANAGED MEDICAID] |percent standard_charge|[payer_CARE FIRST|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_CARE FIRST|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_CIGNA BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] |percent standard_charge|[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_CIGNA MEDICARE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_CIGNA MEDICARE ADVANTAGE|MANAGED MEDICARE] |percent standard_charge|[payer_CIGNA MEDICARE ADVANTAGE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CIGNA MEDICARE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_CMDP|MANAGED MEDICAID] standard_charge|[payer_CMDP|MANAGED MEDICAID] |percent standard_charge|[payer_CMDP|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_CMDP|MANAGED MEDICAID] standard_charge|[payer_COM PSYCH CORP|COMMERCIAL] standard_charge|[payer_COM PSYCH CORP|COMMERCIAL] |percent standard_charge|[payer_COM PSYCH CORP|COMMERCIAL] |contracting_method additional_payer_notes |[payer_COM PSYCH CORP|COMMERCIAL] standard_charge|[payer_DCS CHP MERCY CARE|MANAGED MEDICAID] standard_charge|[payer_DCS CHP MERCY CARE|MANAGED MEDICAID] |percent standard_charge|[payer_DCS CHP MERCY CARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_DCS CHP MERCY CARE|MANAGED MEDICAID] standard_charge|[payer_DES ACYF|LOCAL GOVT] standard_charge|[payer_DES ACYF|LOCAL GOVT] |percent standard_charge|[payer_DES ACYF|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_DES ACYF|LOCAL GOVT] 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_FORT DEFIANCE INDIAN HOSP|COMMERCIAL] standard_charge|[payer_FORT DEFIANCE INDIAN HOSP|COMMERCIAL] |percent standard_charge|[payer_FORT DEFIANCE INDIAN HOSP|COMMERCIAL] |contracting_method additional_payer_notes |[payer_FORT DEFIANCE INDIAN HOSP|COMMERCIAL] standard_charge|[payer_GEHA ASA|HMO/PPO] standard_charge|[payer_GEHA ASA|HMO/PPO] |percent standard_charge|[payer_GEHA ASA|HMO/PPO] |contracting_method additional_payer_notes |[payer_GEHA ASA|HMO/PPO] standard_charge|[payer_GILA RIVER HEALTHCARE|COMMERCIAL] standard_charge|[payer_GILA RIVER HEALTHCARE|COMMERCIAL] |percent standard_charge|[payer_GILA RIVER HEALTHCARE|COMMERCIAL] |contracting_method additional_payer_notes |[payer_GILA RIVER HEALTHCARE|COMMERCIAL] standard_charge|[payer_HEALTH CHOICE GENERATIONS|MANAGED MEDICARE] standard_charge|[payer_HEALTH CHOICE GENERATIONS|MANAGED MEDICARE] |percent standard_charge|[payer_HEALTH CHOICE GENERATIONS|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HEALTH CHOICE GENERATIONS|MANAGED MEDICARE] standard_charge|[payer_HEALTHCHOICE AZ|MANAGED MEDICAID] standard_charge|[payer_HEALTHCHOICE AZ|MANAGED MEDICAID] |percent standard_charge|[payer_HEALTHCHOICE AZ|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_HEALTHCHOICE AZ|MANAGED MEDICAID] standard_charge|[payer_HMA|COMMERCIAL] standard_charge|[payer_HMA|COMMERCIAL] |percent standard_charge|[payer_HMA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HMA|COMMERCIAL] standard_charge|[payer_HMA HAWAII|COMMERCIAL] standard_charge|[payer_HMA HAWAII|COMMERCIAL] |percent standard_charge|[payer_HMA HAWAII|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HMA HAWAII|COMMERCIAL] standard_charge|[payer_HMC HEALTHWORKS|HMO/PPO] standard_charge|[payer_HMC HEALTHWORKS|HMO/PPO] |percent standard_charge|[payer_HMC HEALTHWORKS|HMO/PPO] |contracting_method additional_payer_notes |[payer_HMC HEALTHWORKS|HMO/PPO] standard_charge|[payer_HOLMAN GROUP|COMMERCIAL] standard_charge|[payer_HOLMAN GROUP|COMMERCIAL] |percent standard_charge|[payer_HOLMAN GROUP|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HOLMAN GROUP|COMMERCIAL] standard_charge|[payer_HOLMAN GROUP ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_HOLMAN GROUP ADVANTAGE|MANAGED MEDICARE] |percent standard_charge|[payer_HOLMAN GROUP ADVANTAGE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HOLMAN GROUP ADVANTAGE|MANAGED MEDICARE] 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_INTEL CONNECTED CARE|HMO/PPO] standard_charge|[payer_INTEL CONNECTED CARE|HMO/PPO] |percent standard_charge|[payer_INTEL CONNECTED CARE|HMO/PPO] |contracting_method additional_payer_notes |[payer_INTEL CONNECTED CARE|HMO/PPO] standard_charge|[payer_INTERNATIONAL BENEFITS|COMMERCIAL] standard_charge|[payer_INTERNATIONAL BENEFITS|COMMERCIAL] |percent standard_charge|[payer_INTERNATIONAL BENEFITS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_INTERNATIONAL BENEFITS|COMMERCIAL] standard_charge|[payer_KAYENTA HEALTH CENTER|COMMERCIAL] standard_charge|[payer_KAYENTA HEALTH CENTER|COMMERCIAL] |percent standard_charge|[payer_KAYENTA HEALTH CENTER|COMMERCIAL] |contracting_method additional_payer_notes |[payer_KAYENTA HEALTH CENTER|COMMERCIAL] standard_charge|[payer_LINECO|COMMERCIAL] standard_charge|[payer_LINECO|COMMERCIAL] |percent standard_charge|[payer_LINECO|COMMERCIAL] |contracting_method additional_payer_notes |[payer_LINECO|COMMERCIAL] standard_charge|[payer_MAGELLAN MENTAL HEALTH|HMO/PPO] standard_charge|[payer_MAGELLAN MENTAL HEALTH|HMO/PPO] |percent standard_charge|[payer_MAGELLAN MENTAL HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_MAGELLAN MENTAL HEALTH|HMO/PPO] 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_MEDICA|COMMERCIAL] standard_charge|[payer_MEDICA|COMMERCIAL] |percent standard_charge|[payer_MEDICA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MEDICA|COMMERCIAL] standard_charge|[payer_MEDICARE NORIDIAN|MEDICARE] standard_charge|[payer_MEDICARE NORIDIAN|MEDICARE] |percent standard_charge|[payer_MEDICARE NORIDIAN|MEDICARE] |contracting_method additional_payer_notes |[payer_MEDICARE NORIDIAN|MEDICARE] standard_charge|[payer_MERCY CARE ACC|MANAGED MEDICAID] standard_charge|[payer_MERCY CARE ACC|MANAGED MEDICAID] |percent standard_charge|[payer_MERCY CARE ACC|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MERCY CARE ACC|MANAGED MEDICAID] standard_charge|[payer_MERCY CARE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_MERCY CARE ADVANTAGE|MANAGED MEDICARE] |percent standard_charge|[payer_MERCY CARE ADVANTAGE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MERCY CARE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_MERCY CARE RBHA|MANAGED MEDICAID] standard_charge|[payer_MERCY CARE RBHA|MANAGED MEDICAID] |percent standard_charge|[payer_MERCY CARE RBHA|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MERCY CARE RBHA|MANAGED MEDICAID] standard_charge|[payer_MERITAIN HEALTH|COMMERCIAL] standard_charge|[payer_MERITAIN HEALTH|COMMERCIAL] |percent standard_charge|[payer_MERITAIN HEALTH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MERITAIN HEALTH|COMMERCIAL] standard_charge|[payer_MERTAIN AETNA|HMO/PPO] standard_charge|[payer_MERTAIN AETNA|HMO/PPO] |percent standard_charge|[payer_MERTAIN AETNA|HMO/PPO] |contracting_method additional_payer_notes |[payer_MERTAIN AETNA|HMO/PPO] standard_charge|[payer_MINES AND ASSOCIATES|COMMERCIAL] standard_charge|[payer_MINES AND ASSOCIATES|COMMERCIAL] |percent standard_charge|[payer_MINES AND ASSOCIATES|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MINES AND ASSOCIATES|COMMERCIAL] standard_charge|[payer_MISC COMMERCIAL|COMMERCIAL] standard_charge|[payer_MISC COMMERCIAL|COMMERCIAL] |percent standard_charge|[payer_MISC COMMERCIAL|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MISC COMMERCIAL|COMMERCIAL] standard_charge|[payer_MOLINA COMPLETE CARE|MANAGED MEDICAID] standard_charge|[payer_MOLINA COMPLETE CARE|MANAGED MEDICAID] |percent standard_charge|[payer_MOLINA COMPLETE CARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MOLINA COMPLETE CARE|MANAGED MEDICAID] standard_charge|[payer_MUTUTAL OF OMAHA SUPP|HMO/PPO] standard_charge|[payer_MUTUTAL OF OMAHA SUPP|HMO/PPO] |percent standard_charge|[payer_MUTUTAL OF OMAHA SUPP|HMO/PPO] |contracting_method additional_payer_notes |[payer_MUTUTAL OF OMAHA SUPP|HMO/PPO] standard_charge|[payer_NH MEDICAID STATE|MEDICAID: OUT OF STATE] standard_charge|[payer_NH MEDICAID STATE|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NH MEDICAID STATE|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NH MEDICAID STATE|MEDICAID: OUT OF STATE] standard_charge|[payer_OXFORD HEALTH PLANS|HMO/PPO] standard_charge|[payer_OXFORD HEALTH PLANS|HMO/PPO] |percent standard_charge|[payer_OXFORD HEALTH PLANS|HMO/PPO] |contracting_method additional_payer_notes |[payer_OXFORD HEALTH PLANS|HMO/PPO] standard_charge|[payer_P3 AZ HEALTH PARTNERS|MANAGED MEDICARE] standard_charge|[payer_P3 AZ HEALTH PARTNERS|MANAGED MEDICARE] |percent standard_charge|[payer_P3 AZ HEALTH PARTNERS|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_P3 AZ HEALTH PARTNERS|MANAGED MEDICARE] standard_charge|[payer_PHILADELPHIA AMERICAN|COMMERCIAL] standard_charge|[payer_PHILADELPHIA AMERICAN|COMMERCIAL] |percent standard_charge|[payer_PHILADELPHIA AMERICAN|COMMERCIAL] |contracting_method additional_payer_notes |[payer_PHILADELPHIA AMERICAN|COMMERCIAL] standard_charge|[payer_POINT COMFORT UNDERWRITER|HMO/PPO] standard_charge|[payer_POINT COMFORT UNDERWRITER|HMO/PPO] |percent standard_charge|[payer_POINT COMFORT UNDERWRITER|HMO/PPO] |contracting_method additional_payer_notes |[payer_POINT COMFORT UNDERWRITER|HMO/PPO] standard_charge|[payer_PRESBYTERIAN- MEDI|MANAGED MEDICAID] standard_charge|[payer_PRESBYTERIAN- MEDI|MANAGED MEDICAID] |percent standard_charge|[payer_PRESBYTERIAN- MEDI|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_PRESBYTERIAN- MEDI|MANAGED MEDICAID] standard_charge|[payer_SCOTT AND WHITE|HMO/PPO] standard_charge|[payer_SCOTT AND WHITE|HMO/PPO] |percent standard_charge|[payer_SCOTT AND WHITE|HMO/PPO] |contracting_method additional_payer_notes |[payer_SCOTT AND WHITE|HMO/PPO] standard_charge|[payer_SUMMIT NETWORK|HMO/PPO] standard_charge|[payer_SUMMIT NETWORK|HMO/PPO] |percent standard_charge|[payer_SUMMIT NETWORK|HMO/PPO] |contracting_method additional_payer_notes |[payer_SUMMIT NETWORK|HMO/PPO] standard_charge|[payer_TALL TREE ADMINISTRATORS|COMMERCIAL] standard_charge|[payer_TALL TREE ADMINISTRATORS|COMMERCIAL] |percent standard_charge|[payer_TALL TREE ADMINISTRATORS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_TALL TREE ADMINISTRATORS|COMMERCIAL] standard_charge|[payer_TRIBAL PASCUA YAQUI|MANAGED MEDICAID] standard_charge|[payer_TRIBAL PASCUA YAQUI|MANAGED MEDICAID] |percent standard_charge|[payer_TRIBAL PASCUA YAQUI|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_TRIBAL PASCUA YAQUI|MANAGED MEDICAID] standard_charge|[payer_TRIBAL SALT RIVER PIMA|MANAGED MEDICAID] standard_charge|[payer_TRIBAL SALT RIVER PIMA|MANAGED MEDICAID] |percent standard_charge|[payer_TRIBAL SALT RIVER PIMA|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_TRIBAL SALT RIVER PIMA|MANAGED MEDICAID] standard_charge|[payer_TRICARE FOR LIFE|TRICARE] standard_charge|[payer_TRICARE FOR LIFE|TRICARE] |percent standard_charge|[payer_TRICARE FOR LIFE|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE FOR LIFE|TRICARE] standard_charge|[payer_TRICARE WEST REGION|TRICARE] standard_charge|[payer_TRICARE WEST REGION|TRICARE] |percent standard_charge|[payer_TRICARE WEST REGION|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE WEST REGION|TRICARE] standard_charge|[payer_UBH MANAGED MEDICARE|MANAGED MEDICARE] standard_charge|[payer_UBH MANAGED MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_UBH MANAGED MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UBH MANAGED MEDICARE|MANAGED MEDICARE] standard_charge|[payer_UHC COMMUNITY PLAN AZ|MANAGED MEDICAID] standard_charge|[payer_UHC COMMUNITY PLAN AZ|MANAGED MEDICAID] |percent standard_charge|[payer_UHC COMMUNITY PLAN AZ|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_UHC COMMUNITY PLAN AZ|MANAGED MEDICAID] standard_charge|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE] standard_charge|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE] |percent standard_charge|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UHC DUAL COMPLETE|MANAGED MEDICARE] standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO] standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO] |percent standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHC SHARED SERVICES|HMO/PPO] standard_charge|[payer_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_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_WELLCARE ADV|MANAGED MEDICARE] standard_charge|[payer_WELLCARE ADV|MANAGED MEDICARE] |percent standard_charge|[payer_WELLCARE ADV|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_WELLCARE ADV|MANAGED MEDICARE] standard_charge|[payer_WHITERIVER INDIAN HOSPITA|COMMERCIAL] standard_charge|[payer_WHITERIVER INDIAN HOSPITA|COMMERCIAL] |percent standard_charge|[payer_WHITERIVER INDIAN HOSPITA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_WHITERIVER INDIAN HOSPITA|COMMERCIAL] standard_charge|[payer_WPS VA|VETERANS ADMIN] standard_charge|[payer_WPS VA|VETERANS ADMIN] |percent standard_charge|[payer_WPS VA|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_WPS VA|VETERANS ADMIN] ROOM AND BOARD ADOL PSYCH 124 RC facility inpatient 2165.00 800 853.12 3505 2165 per diem 912 per diem 1135 per diem 1135 per diem 1135 per diem 1297.06 per diem 853.12 per diem 1297.06 per diem 1297.06 per diem 1297.06 per diem 1297.06 per diem 1297.06 per diem 940 per diem 1070 per diem 2165 per diem 2165 per diem 975 per diem 975 per diem 975 per diem 1534.26 per diem 2165 per diem 900 per diem 1322.99 per diem 870.19 per diem 1004 per diem 1550.32 per diem 1239.68 per diem 1297.05 per diem 2165 per diem 1165 per diem 853.12 per diem 2165 per diem 1491.59 per diem 1249.49 per diem 1004 per diem 2165 per diem 1135 per diem 2165 per diem 1000 per diem 1555.51 per diem 2165 per diem 2165 per diem 1520 per diem 2165 per diem 2165 per diem 1900 per diem 928 per diem 2165 per diem 2165 per diem 2165 per diem 875 per diem 1525 per diem 2165 per diem 1491.59 per diem 1890.7 per diem 2165 per diem 1135 per diem 2165 per diem 3505 per diem 1297.05 per diem 2165 per diem 3505 per diem 940 per diem 2165 per diem 2165 per diem 1340 per diem 1165 per diem 875 per diem 2165 per diem 1465.5 per diem 1094 per diem 1683 per diem 1297.05 per diem 940 per diem 940 per diem 940 per diem 2165 per diem 2165 per diem 2165 per diem ROOM AND BOARD ADULT DETOX 126 RC facility inpatient 2165.00 800 433.1 2213.55 2165 per diem 752 per diem 1041 per diem 1041 per diem 1041 per diem 1526.6 per diem 773.16 per diem 1526.6 per diem 1526.6 per diem 1526.6 per diem 1526.6 per diem 1526.6 per diem 775 per diem 981 per diem 2165 per diem 2165 per diem 1794.24 per diem 2165 per diem 1557.12 per diem 788.62 per diem 2165 per diem 1309.14 per diem 998.5 per diem 1526.6 per diem 2165 per diem 1066 per diem 773.16 per diem 2165 per diem 1755.57 per diem 433.1 per diem 1004 per diem 2165 per diem 1041 per diem 2165 per diem 1000 per diem 1911.45 per diem 2165 per diem 2165 per diem 990 per diem 2165 per diem 2165 per diem 950 per diem 2165 per diem 2165 per diem 2165 per diem 2165 per diem 2165 per diem 990 per diem 2165 per diem 1755.57 per diem 2213.55 per diem 2165 per diem 1041 per diem 2165 per diem 2165 per diem 1526.6 per diem 2165 per diem 2165 per diem 775 per diem 2165 per diem 2165 per diem 1066 per diem 2165 per diem 2165 per diem 1388.98 per diem 1094 per diem 1094 per diem 1546.34 per diem 775 per diem 775 per diem 775 per diem 2165 per diem 2165 per diem 2165 per diem ROOM AND BOARD BHIF ADMIN 160 RC facility inpatient 1340.00 0 452.59 709.17 709.17 per diem 709.17 per diem 709.17 per diem 709.17 per diem 709.17 per diem 709.17 per diem 709.17 per diem 574.75 per diem 452.59 per diem 709.17 per diem ROOM & BOARD ADMIN 160 RC facility inpatient 2165.00 0 452.59 709.17 709.17 per diem 709.17 per diem 709.17 per diem 709.17 per diem 709.17 per diem 709.17 per diem 709.17 per diem 574.75 per diem 452.59 per diem 709.17 per diem ROOM AND BOARD-RTC LOA THER. 183 RC facility inpatient 140.00 0 122.09 433.1 125.14 per diem 125.14 per diem 125.14 per diem 125.14 per diem 125.14 per diem 125.14 per diem 143.91 per diem 127.64 per diem 125.14 per diem 156.42 per diem 433.1 per diem 143.91 per diem 143.91 per diem 181.45 per diem 125.14 per diem 140 per diem 122.09 per diem INTENSIVE OUTPATIENT PROGRAM PSYCH 905 RC facility outpatient 618.00 200 133 618 157 per diem 226 per diem 226 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 377.81 per diem 157 per diem 618 per diem 204 per diem 216 per diem 216 per diem 618 per diem 216 per diem 216 per diem 200 per diem 377.81 per diem 377.81 per diem 373.54 per diem 377.81 per diem 237 per diem 237 per diem 618 per diem 396.7 per diem 226 per diem 204 per diem 285 per diem 275 per diem 133 per diem 206 per diem 250 per diem 618 per diem 396.7 per diem 618 per diem 396.7 per diem 226 per diem 618 per diem 377.81 per diem 237 per diem 360 per diem 157 per diem 370.41 per diem 157 per diem 157 per diem 157 per diem 157 per diem PARTIAL HOSPITAL PROGRAM CD ADULT 912 RC facility outpatient 1080.00 300 248 1085 300 per diem 560 per diem 560 per diem 1080 per diem 1080 per diem 1080 per diem 1080 per diem 1080 per diem 300 per diem 1080 per diem 248 per diem 248 per diem 1085 per diem 248 per diem 248 per diem 540 per diem 1080 per diem 1080 per diem 478.54 per diem 1080 per diem 536 per diem 536 per diem 1080 per diem 1080 per diem 560 per diem 1080 per diem 400 per diem 475 per diem 400 per diem 1080 per diem 1080 per diem 560 per diem 1080 per diem 536 per diem 360 per diem 300 per diem 1080 per diem 300 per diem 300 per diem 300 per diem 300 per diem CD PROCESS GROUP 1 915 RC facility outpatient 206.00 0 206 618 618 per diem 206 per diem 618 per diem 618 per diem MH TELE PROCESS GP 1 915 RC facility outpatient 206.00 0 206 618 618 per diem 206 per diem 618 per diem 618 per diem ROOM AND BOARD-RTC PSY SECURE 1001 RC facility outpatient 1340.00 400 388.5 1340 437 per diem 560 per diem 443.94 per diem 443.94 per diem 443.94 per diem 443.94 per diem 443.94 per diem 443.94 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 510.51 per diem 388.5 per diem 388.5 per diem 388.5 per diem 388.5 per diem 404 per diem 452.8 per diem 443.93 per diem 1340 per diem 563 per diem 510.51 per diem 433.1 per diem 565 per diem 437 per diem 510.51 per diem 1340 per diem 530 per diem 950 per diem 459 per diem 463 per diem 535 per diem 510.51 per diem 643.68 per diem 1340 per diem 437 per diem 1340 per diem 1340 per diem 443.93 per diem 1340 per diem 490 per diem 1340 per diem 563 per diem 433.1 per diem 520 per diem 589 per diem 443.93 per diem 577 per diem 577 per diem ROOM AND BOARD RTC CD YOUTH 1002 RC facility outpatient 1340.00 388.5 1340 437 per diem 560 per diem 753.44 per diem 753.44 per diem 753.44 per diem 753.44 per diem 753.44 per diem 753.44 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 428 per diem 866.45 per diem 388.5 per diem 388.5 per diem 388.5 per diem 388.5 per diem 404 per diem 768.5 per diem 753.44 per diem 563 per diem 866.44 per diem 433.1 per diem 565 per diem 437 per diem 866.45 per diem 530 per diem 850 per diem 463 per diem 866.44 per diem 1092.47 per diem 1340 per diem 437 per diem 1340 per diem 1340 per diem 753.44 per diem 1340 per diem 1340 per diem 563 per diem 433.1 per diem 520 per diem 773.17 per diem 577 per diem 577 per diem