"hospital_Crossroads Regional Hosptial, LLC" last_updated_ 2023-12-31 version_1 "hospital_Alexandria, Louisiana" hospital_address 44 Versailles Boulevard license_2203781934 | LA "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded in this machine-readable file is true, accurate, and complete as of the date indicated in this file" description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AETNA|COMMERCIAL] standard_charge|[payer_AETNA|COMMERCIAL] |percent standard_charge|[payer_AETNA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_AETNA|COMMERCIAL] standard_charge|[payer_AETNA BETTER HEALTH|MANAGED MEDICAID] standard_charge|[payer_AETNA BETTER HEALTH|MANAGED MEDICAID] |percent standard_charge|[payer_AETNA BETTER HEALTH|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AETNA BETTER HEALTH|MANAGED MEDICAID] standard_charge|[payer_AETNA COVENTRY|HMO/PPO] standard_charge|[payer_AETNA COVENTRY|HMO/PPO] |percent standard_charge|[payer_AETNA COVENTRY|HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA COVENTRY|HMO/PPO] standard_charge|[payer_AETNA MCR|MANAGED MEDICARE] standard_charge|[payer_AETNA MCR|MANAGED MEDICARE] |percent standard_charge|[payer_AETNA MCR|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA MCR|MANAGED MEDICARE] standard_charge|[payer_AETNA MCR SUPPLEMENT CLAI|COMMERCIAL] standard_charge|[payer_AETNA MCR SUPPLEMENT CLAI|COMMERCIAL] |percent standard_charge|[payer_AETNA MCR SUPPLEMENT CLAI|COMMERCIAL] |contracting_method additional_payer_notes |[payer_AETNA MCR SUPPLEMENT CLAI|COMMERCIAL] standard_charge|[payer_ALL SAVERS UHC|HMO/PPO] standard_charge|[payer_ALL SAVERS UHC|HMO/PPO] |percent standard_charge|[payer_ALL SAVERS UHC|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALL SAVERS UHC|HMO/PPO] standard_charge|[payer_AMERIHEALTH CARITAS|MANAGED MEDICAID] standard_charge|[payer_AMERIHEALTH CARITAS|MANAGED MEDICAID] |percent standard_charge|[payer_AMERIHEALTH CARITAS|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AMERIHEALTH CARITAS|MANAGED MEDICAID] standard_charge|[payer_ARKIDS 1ST|MEDICAID: OUT OF STATE] standard_charge|[payer_ARKIDS 1ST|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ARKIDS 1ST|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ARKIDS 1ST|MEDICAID: OUT OF STATE] 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 OF LOUISIANA|BLUE CROSS] standard_charge|[payer_BCBS OF LOUISIANA|BLUE CROSS] |percent standard_charge|[payer_BCBS OF LOUISIANA|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OF LOUISIANA|BLUE CROSS] standard_charge|[payer_BCBS OUT OF STATE PLAN|BLUE CROSS] standard_charge|[payer_BCBS OUT OF STATE PLAN|BLUE CROSS] |percent standard_charge|[payer_BCBS OUT OF STATE PLAN|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OUT OF STATE PLAN|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_BENEFIT ADMINISTRATVE SVC|HMO/PPO] standard_charge|[payer_BENEFIT ADMINISTRATVE SVC|HMO/PPO] |percent standard_charge|[payer_BENEFIT ADMINISTRATVE SVC|HMO/PPO] |contracting_method additional_payer_notes |[payer_BENEFIT ADMINISTRATVE SVC|HMO/PPO] standard_charge|[payer_CENPATICO BEHAVIORAL HEAL|COMMERCIAL] standard_charge|[payer_CENPATICO BEHAVIORAL HEAL|COMMERCIAL] |percent standard_charge|[payer_CENPATICO BEHAVIORAL HEAL|COMMERCIAL] |contracting_method additional_payer_notes |[payer_CENPATICO BEHAVIORAL HEAL|COMMERCIAL] 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 BEHAVIORAL|HMO/PPO] standard_charge|[payer_CIGNA BEHAVIORAL|HMO/PPO] |percent standard_charge|[payer_CIGNA BEHAVIORAL|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA BEHAVIORAL|HMO/PPO] standard_charge|[payer_COMPSYCH|HMO/PPO] standard_charge|[payer_COMPSYCH|HMO/PPO] |percent standard_charge|[payer_COMPSYCH|HMO/PPO] |contracting_method additional_payer_notes |[payer_COMPSYCH|HMO/PPO] standard_charge|[payer_DCFS|LOCAL GOVT] standard_charge|[payer_DCFS|LOCAL GOVT] |percent standard_charge|[payer_DCFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_DCFS|LOCAL GOVT] standard_charge|[payer_DEVOTED HEALTH PLAN TEXAS|MANAGED MEDICARE] standard_charge|[payer_DEVOTED HEALTH PLAN TEXAS|MANAGED MEDICARE] |percent standard_charge|[payer_DEVOTED HEALTH PLAN TEXAS|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_DEVOTED HEALTH PLAN TEXAS|MANAGED MEDICARE] standard_charge|[payer_FIRST CHOICE|MEDICAID: OUT OF STATE] standard_charge|[payer_FIRST CHOICE|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_FIRST CHOICE|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_FIRST CHOICE|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_FLORIDA MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_FLORIDA MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_FLORIDA MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_FOX EVERETT|HMO/PPO] standard_charge|[payer_FOX EVERETT|HMO/PPO] |percent standard_charge|[payer_FOX EVERETT|HMO/PPO] |contracting_method additional_payer_notes |[payer_FOX EVERETT|HMO/PPO] 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_GILSBAR|HMO/PPO] standard_charge|[payer_GILSBAR|HMO/PPO] |percent standard_charge|[payer_GILSBAR|HMO/PPO] |contracting_method additional_payer_notes |[payer_GILSBAR|HMO/PPO] standard_charge|[payer_GROUP & PENSION ADMINSTR|HMO/PPO] standard_charge|[payer_GROUP & PENSION ADMINSTR|HMO/PPO] |percent standard_charge|[payer_GROUP & PENSION ADMINSTR|HMO/PPO] |contracting_method additional_payer_notes |[payer_GROUP & PENSION ADMINSTR|HMO/PPO] standard_charge|[payer_GROUP PLAN ADMINISTRATORS|COMMERCIAL] standard_charge|[payer_GROUP PLAN ADMINISTRATORS|COMMERCIAL] |percent standard_charge|[payer_GROUP PLAN ADMINISTRATORS|COMMERCIAL] |contracting_method additional_payer_notes |[payer_GROUP PLAN ADMINISTRATORS|COMMERCIAL] standard_charge|[payer_GWL/UHCG ASSISTANCE CLAIM|COMMERCIAL] standard_charge|[payer_GWL/UHCG ASSISTANCE CLAIM|COMMERCIAL] |percent standard_charge|[payer_GWL/UHCG ASSISTANCE CLAIM|COMMERCIAL] |contracting_method additional_payer_notes |[payer_GWL/UHCG ASSISTANCE CLAIM|COMMERCIAL] standard_charge|[payer_HEALTH PLUS OF LOUISIANA|COMMERCIAL] standard_charge|[payer_HEALTH PLUS OF LOUISIANA|COMMERCIAL] |percent standard_charge|[payer_HEALTH PLUS OF LOUISIANA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HEALTH PLUS OF LOUISIANA|COMMERCIAL] standard_charge|[payer_HEALTHNET FEDERAL SRV LLC|TRICARE] standard_charge|[payer_HEALTHNET FEDERAL SRV LLC|TRICARE] |percent standard_charge|[payer_HEALTHNET FEDERAL SRV LLC|TRICARE] |contracting_method additional_payer_notes |[payer_HEALTHNET FEDERAL SRV LLC|TRICARE] standard_charge|[payer_HEALTHY BLUE|MANAGED MEDICAID] standard_charge|[payer_HEALTHY BLUE|MANAGED MEDICAID] |percent standard_charge|[payer_HEALTHY BLUE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_HEALTHY BLUE|MANAGED MEDICAID] standard_charge|[payer_HEALTHY BLUE DUAL ADVANTA|MANAGED MEDICARE] standard_charge|[payer_HEALTHY BLUE DUAL ADVANTA|MANAGED MEDICARE] |percent standard_charge|[payer_HEALTHY BLUE DUAL ADVANTA|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HEALTHY BLUE DUAL ADVANTA|MANAGED MEDICARE] standard_charge|[payer_HUMANA COMMERCIAL|COMMERCIAL] standard_charge|[payer_HUMANA COMMERCIAL|COMMERCIAL] |percent standard_charge|[payer_HUMANA COMMERCIAL|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HUMANA COMMERCIAL|COMMERCIAL] standard_charge|[payer_HUMANA GOLD CHOICE|MANAGED MEDICARE] standard_charge|[payer_HUMANA GOLD CHOICE|MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA GOLD CHOICE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA GOLD CHOICE|MANAGED MEDICARE] standard_charge|[payer_HUMANA HEALTHY HORIZON|MANAGED MEDICAID] standard_charge|[payer_HUMANA HEALTHY HORIZON|MANAGED MEDICAID] |percent standard_charge|[payer_HUMANA HEALTHY HORIZON|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_HUMANA HEALTHY HORIZON|MANAGED MEDICAID] standard_charge|[payer_INTERFACE EAP|HMO/PPO] standard_charge|[payer_INTERFACE EAP|HMO/PPO] |percent standard_charge|[payer_INTERFACE EAP|HMO/PPO] |contracting_method additional_payer_notes |[payer_INTERFACE EAP|HMO/PPO] standard_charge|[payer_LOUISIANA ARMY NAT GUARD|LOCAL GOVT] standard_charge|[payer_LOUISIANA ARMY NAT GUARD|LOCAL GOVT] |percent standard_charge|[payer_LOUISIANA ARMY NAT GUARD|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_LOUISIANA ARMY NAT GUARD|LOCAL GOVT] standard_charge|[payer_LOUISIANA HEALTHCARE CONN|MANAGED MEDICAID] standard_charge|[payer_LOUISIANA HEALTHCARE CONN|MANAGED MEDICAID] |percent standard_charge|[payer_LOUISIANA HEALTHCARE CONN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_LOUISIANA HEALTHCARE CONN|MANAGED MEDICAID] standard_charge|[payer_MAGELLAN BEHAVIORAL HEALT|MANAGED MEDICAID] standard_charge|[payer_MAGELLAN BEHAVIORAL HEALT|MANAGED MEDICAID] |percent standard_charge|[payer_MAGELLAN BEHAVIORAL HEALT|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MAGELLAN BEHAVIORAL HEALT|MANAGED MEDICAID] standard_charge|[payer_MAGELLAN DEVOTED HLTH MM|COMMERCIAL] standard_charge|[payer_MAGELLAN DEVOTED HLTH MM|COMMERCIAL] |percent standard_charge|[payer_MAGELLAN DEVOTED HLTH MM|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MAGELLAN DEVOTED HLTH MM|COMMERCIAL] standard_charge|[payer_MAGELLAN HMO|HMO/PPO] standard_charge|[payer_MAGELLAN HMO|HMO/PPO] |percent standard_charge|[payer_MAGELLAN HMO|HMO/PPO] |contracting_method additional_payer_notes |[payer_MAGELLAN HMO|HMO/PPO] standard_charge|[payer_MAILHANDLERS BENEFIT PLAN|HMO/PPO] standard_charge|[payer_MAILHANDLERS BENEFIT PLAN|HMO/PPO] |percent standard_charge|[payer_MAILHANDLERS BENEFIT PLAN|HMO/PPO] |contracting_method additional_payer_notes |[payer_MAILHANDLERS BENEFIT PLAN|HMO/PPO] standard_charge|[payer_MCAID PENDING LOUISIANA|PENDING MEDICAID] standard_charge|[payer_MCAID PENDING LOUISIANA|PENDING MEDICAID] |percent standard_charge|[payer_MCAID PENDING LOUISIANA|PENDING MEDICAID] |contracting_method additional_payer_notes |[payer_MCAID PENDING LOUISIANA|PENDING MEDICAID] standard_charge|[payer_MCD HEALTH PLAN OF NEVADA|MEDICAID: OUT OF STATE] standard_charge|[payer_MCD HEALTH PLAN OF NEVADA|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MCD HEALTH PLAN OF NEVADA|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MCD HEALTH PLAN OF NEVADA|MEDICAID: OUT OF STATE] standard_charge|[payer_MEDICAID MOLINA LA|MEDICAID ] standard_charge|[payer_MEDICAID MOLINA LA|MEDICAID ] |percent standard_charge|[payer_MEDICAID MOLINA LA|MEDICAID ] |contracting_method additional_payer_notes |[payer_MEDICAID MOLINA LA|MEDICAID ] standard_charge|[payer_MEDICAID QMB|MEDICAID ] standard_charge|[payer_MEDICAID QMB|MEDICAID ] |percent standard_charge|[payer_MEDICAID QMB|MEDICAID ] |contracting_method additional_payer_notes |[payer_MEDICAID QMB|MEDICAID ] standard_charge|[payer_MEDICAID TAKECHARGE|MEDICAID ] standard_charge|[payer_MEDICAID TAKECHARGE|MEDICAID ] |percent standard_charge|[payer_MEDICAID TAKECHARGE|MEDICAID ] |contracting_method additional_payer_notes |[payer_MEDICAID TAKECHARGE|MEDICAID ] standard_charge|[payer_MEDICAID TX|MEDICAID: OUT OF STATE] standard_charge|[payer_MEDICAID TX|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MEDICAID TX|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MEDICAID TX|MEDICAID: OUT OF STATE] 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_MENTAL HEALTH NETWORK|HMO/PPO] standard_charge|[payer_MENTAL HEALTH NETWORK|HMO/PPO] |percent standard_charge|[payer_MENTAL HEALTH NETWORK|HMO/PPO] |contracting_method additional_payer_notes |[payer_MENTAL HEALTH NETWORK|HMO/PPO] standard_charge|[payer_MERIDIANHEALTH|MEDICAID: OUT OF STATE] standard_charge|[payer_MERIDIANHEALTH|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MERIDIANHEALTH|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MERIDIANHEALTH|MEDICAID: OUT OF STATE] standard_charge|[payer_METRO HEALTH PLUS|MEDICAID: OUT OF STATE] standard_charge|[payer_METRO HEALTH PLUS|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_METRO HEALTH PLUS|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_METRO HEALTH PLUS|MEDICAID: OUT OF STATE] standard_charge|[payer_MHNET COVENTRY|COMMERCIAL] standard_charge|[payer_MHNET COVENTRY|COMMERCIAL] |percent standard_charge|[payer_MHNET COVENTRY|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MHNET COVENTRY|COMMERCIAL] standard_charge|[payer_MISC INSURANCE|COMMERCIAL] standard_charge|[payer_MISC INSURANCE|COMMERCIAL] |percent standard_charge|[payer_MISC INSURANCE|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MISC INSURANCE|COMMERCIAL] standard_charge|[payer_MISSISSIPPI MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_MISSISSIPPI MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MISSISSIPPI MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MISSISSIPPI MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_MOLINA HEALTHCARE OF OHIO|MANAGED MEDICARE] standard_charge|[payer_MOLINA HEALTHCARE OF OHIO|MANAGED MEDICARE] |percent standard_charge|[payer_MOLINA HEALTHCARE OF OHIO|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_MOLINA HEALTHCARE OF OHIO|MANAGED MEDICARE] standard_charge|[payer_NEW YORK MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_NEW YORK MEDICAID|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_NEW YORK MEDICAID|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_NEW YORK MEDICAID|MEDICAID: OUT OF STATE] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO] |percent standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|MANAGED MEDICAID] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|MANAGED MEDICAID] |percent standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_OPTUM BEHAVIORAL HEALTH|MANAGED MEDICAID] standard_charge|[payer_OPTUM BEHAVIORAL HLTH MCD|MANAGED MEDICAID] standard_charge|[payer_OPTUM BEHAVIORAL HLTH MCD|MANAGED MEDICAID] |percent standard_charge|[payer_OPTUM BEHAVIORAL HLTH MCD|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_OPTUM BEHAVIORAL HLTH MCD|MANAGED MEDICAID] standard_charge|[payer_OPTUM MCR PPO/HMO|HMO/PPO] standard_charge|[payer_OPTUM MCR PPO/HMO|HMO/PPO] |percent standard_charge|[payer_OPTUM MCR PPO/HMO|HMO/PPO] |contracting_method additional_payer_notes |[payer_OPTUM MCR PPO/HMO|HMO/PPO] standard_charge|[payer_OPTUM MCR PPO/HMO|MANAGED MEDICARE] standard_charge|[payer_OPTUM MCR PPO/HMO|MANAGED MEDICARE] |percent standard_charge|[payer_OPTUM MCR PPO/HMO|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_OPTUM MCR PPO/HMO|MANAGED MEDICARE] standard_charge|[payer_OPTUM SAN DIEGO|MEDICAID: OUT OF STATE] standard_charge|[payer_OPTUM SAN DIEGO|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_OPTUM SAN DIEGO|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_OPTUM SAN DIEGO|MEDICAID: OUT OF STATE] standard_charge|[payer_RIVER VALLEY ENTITY|MANAGED MEDICAID] standard_charge|[payer_RIVER VALLEY ENTITY|MANAGED MEDICAID] |percent standard_charge|[payer_RIVER VALLEY ENTITY|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_RIVER VALLEY ENTITY|MANAGED MEDICAID] standard_charge|[payer_SHEET METAL WORKERS NHF|HMO/PPO] standard_charge|[payer_SHEET METAL WORKERS NHF|HMO/PPO] |percent standard_charge|[payer_SHEET METAL WORKERS NHF|HMO/PPO] |contracting_method additional_payer_notes |[payer_SHEET METAL WORKERS NHF|HMO/PPO] standard_charge|[payer_STUDENT ASSURANCE SERVICE|COMMERCIAL] standard_charge|[payer_STUDENT ASSURANCE SERVICE|COMMERCIAL] |percent standard_charge|[payer_STUDENT ASSURANCE SERVICE|COMMERCIAL] |contracting_method additional_payer_notes |[payer_STUDENT ASSURANCE SERVICE|COMMERCIAL] standard_charge|[payer_STUDENT RESOURCES|COMMERCIAL] standard_charge|[payer_STUDENT RESOURCES|COMMERCIAL] |percent standard_charge|[payer_STUDENT RESOURCES|COMMERCIAL] |contracting_method additional_payer_notes |[payer_STUDENT RESOURCES|COMMERCIAL] standard_charge|[payer_TEXAS STARPLUS MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_TEXAS STARPLUS MCD|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_TEXAS STARPLUS MCD|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_TEXAS STARPLUS MCD|MEDICAID: OUT OF STATE] standard_charge|[payer_TRICARE|TRICARE] standard_charge|[payer_TRICARE|TRICARE] |percent standard_charge|[payer_TRICARE|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE|TRICARE] standard_charge|[payer_TRICARE ACTIVE DUTY|TRICARE] standard_charge|[payer_TRICARE ACTIVE DUTY|TRICARE] |percent standard_charge|[payer_TRICARE ACTIVE DUTY|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE ACTIVE DUTY|TRICARE] standard_charge|[payer_TRICARE ACTIVE DUTY2|TRICARE] standard_charge|[payer_TRICARE ACTIVE DUTY2|TRICARE] |percent standard_charge|[payer_TRICARE ACTIVE DUTY2|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE ACTIVE DUTY2|TRICARE] 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 HNFS|TRICARE] standard_charge|[payer_TRICARE WEST HNFS|TRICARE] |percent standard_charge|[payer_TRICARE WEST HNFS|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE WEST HNFS|TRICARE] standard_charge|[payer_TUNICA BILOXI|HMO/PPO] standard_charge|[payer_TUNICA BILOXI|HMO/PPO] |percent standard_charge|[payer_TUNICA BILOXI|HMO/PPO] |contracting_method additional_payer_notes |[payer_TUNICA BILOXI|HMO/PPO] standard_charge|[payer_UBH|HMO/PPO] standard_charge|[payer_UBH|HMO/PPO] |percent standard_charge|[payer_UBH|HMO/PPO] |contracting_method additional_payer_notes |[payer_UBH|HMO/PPO] standard_charge|[payer_UBH CLAIMS|MANAGED MEDICAID] standard_charge|[payer_UBH CLAIMS|MANAGED MEDICAID] |percent standard_charge|[payer_UBH CLAIMS|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_UBH CLAIMS|MANAGED MEDICAID] standard_charge|[payer_UHC DUAL COMPLETE PLAN|MANAGED MEDICARE] standard_charge|[payer_UHC DUAL COMPLETE PLAN|MANAGED MEDICARE] |percent standard_charge|[payer_UHC DUAL COMPLETE PLAN|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UHC DUAL COMPLETE PLAN|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_UHIS|HMO/PPO] standard_charge|[payer_UHIS|HMO/PPO] |percent standard_charge|[payer_UHIS|HMO/PPO] |contracting_method additional_payer_notes |[payer_UHIS|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 HEALTH SHARED SERV|HMO/PPO] standard_charge|[payer_UNITED HEALTH SHARED SERV|HMO/PPO] |percent standard_charge|[payer_UNITED HEALTH SHARED SERV|HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED HEALTH SHARED SERV|HMO/PPO] standard_charge|[payer_UNITED HEALTH SHARED SERV|MANAGED MEDICAID] standard_charge|[payer_UNITED HEALTH SHARED SERV|MANAGED MEDICAID] |percent standard_charge|[payer_UNITED HEALTH SHARED SERV|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_UNITED HEALTH SHARED SERV|MANAGED MEDICAID] standard_charge|[payer_VA CONSOLIDATED FEE UNIT|VETERANS ADMIN] standard_charge|[payer_VA CONSOLIDATED FEE UNIT|VETERANS ADMIN] |percent standard_charge|[payer_VA CONSOLIDATED FEE UNIT|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_VA CONSOLIDATED FEE UNIT|VETERANS ADMIN] standard_charge|[payer_VACCN OPTUM-MEDICAL|VETERANS ADMIN] standard_charge|[payer_VACCN OPTUM-MEDICAL|VETERANS ADMIN] |percent standard_charge|[payer_VACCN OPTUM-MEDICAL|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_VACCN OPTUM-MEDICAL|VETERANS ADMIN] standard_charge|[payer_VANTAGE HEALTH PLAN|COMMERCIAL] standard_charge|[payer_VANTAGE HEALTH PLAN|COMMERCIAL] |percent standard_charge|[payer_VANTAGE HEALTH PLAN|COMMERCIAL] |contracting_method additional_payer_notes |[payer_VANTAGE HEALTH PLAN|COMMERCIAL] standard_charge|[payer_VANTAGE HEALTH PLAN|MANAGED MEDICARE] standard_charge|[payer_VANTAGE HEALTH PLAN|MANAGED MEDICARE] |percent standard_charge|[payer_VANTAGE HEALTH PLAN|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_VANTAGE HEALTH PLAN|MANAGED MEDICARE] standard_charge|[payer_VANTAGE HEALTH PLAN COMM|MANAGED MEDICARE] standard_charge|[payer_VANTAGE HEALTH PLAN COMM|MANAGED MEDICARE] |percent standard_charge|[payer_VANTAGE HEALTH PLAN COMM|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_VANTAGE HEALTH PLAN COMM|MANAGED MEDICARE] standard_charge|[payer_WEB TPA|HMO/PPO] standard_charge|[payer_WEB TPA|HMO/PPO] |percent standard_charge|[payer_WEB TPA|HMO/PPO] |contracting_method additional_payer_notes |[payer_WEB TPA|HMO/PPO] standard_charge|[payer_WELLCARE|MANAGED MEDICARE] standard_charge|[payer_WELLCARE|MANAGED MEDICARE] |percent standard_charge|[payer_WELLCARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_WELLCARE|MANAGED MEDICARE] standard_charge|[payer_ZELIS/GILSBAR|HMO/PPO] standard_charge|[payer_ZELIS/GILSBAR|HMO/PPO] |percent standard_charge|[payer_ZELIS/GILSBAR|HMO/PPO] |contracting_method additional_payer_notes |[payer_ZELIS/GILSBAR|HMO/PPO] ROOM AND BOARD ADOLESCENT-PSYCH 124 RC facility inpatient 2400.00 750 448.06 2400 832 per diem 774.51 per diem 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 528.89 per diem 823.14 per diem 823.14 per diem 823.14 per diem 820 per diem 1120 per diem 448.06 per diem 853 per diem 853 per diem 800 per diem 737.63 per diem 528.89 per diem 528.89 per diem 528.89 per diem 750 per diem 700 per diem 800 per diem 750 per diem 650 per diem 2200 per diem 1600 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1421 per diem 832 per diem 737.63 per diem 528.89 per diem 737.63 per diem 737.63 per diem 737.63 per diem 528.89 per diem 784 per diem 528.89 per diem 528.89 per diem 784 per diem 2400 per diem 528.89 per diem 2200 per diem 528.89 per diem 772 per diem 737.63 per diem 750 per diem 528.89 per diem 600 per diem 750 per diem 2200 per diem 2200 per diem 528.89 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 724.69 per diem 772 per diem 448.06 per diem 772 per diem 750 per diem 700 per diem 772 per diem 750 per diem 1062.6 per diem 1000 per diem 750 per diem 700 per diem ROOM AND BOARD ADULT PSYCH 124 RC facility inpatient 2400.00 750 448.06 2400 832 per diem 774.51 per diem 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 528.89 per diem 823.14 per diem 823.14 per diem 823.14 per diem 820 per diem 1120 per diem 448.06 per diem 853 per diem 853 per diem 800 per diem 737.63 per diem 528.89 per diem 528.89 per diem 528.89 per diem 750 per diem 700 per diem 800 per diem 750 per diem 650 per diem 2200 per diem 1600 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1421 per diem 832 per diem 737.63 per diem 528.89 per diem 737.63 per diem 737.63 per diem 737.63 per diem 528.89 per diem 784 per diem 528.89 per diem 528.89 per diem 784 per diem 2400 per diem 528.89 per diem 2200 per diem 528.89 per diem 772 per diem 737.63 per diem 750 per diem 528.89 per diem 600 per diem 750 per diem 2200 per diem 2200 per diem 528.89 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 724.69 per diem 772 per diem 448.06 per diem 772 per diem 750 per diem 700 per diem 772 per diem 750 per diem 1062.6 per diem 1000 per diem 750 per diem 700 per diem ROOM AND BOARD CHILD-PSYCH 124 RC facility inpatient 2400.00 750 448.06 2400 832 per diem 774.51 per diem 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 528.89 per diem 823.14 per diem 823.14 per diem 823.14 per diem 820 per diem 1120 per diem 448.06 per diem 853 per diem 853 per diem 800 per diem 737.63 per diem 528.89 per diem 528.89 per diem 528.89 per diem 750 per diem 700 per diem 800 per diem 750 per diem 650 per diem 2200 per diem 1600 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1421 per diem 832 per diem 737.63 per diem 528.89 per diem 737.63 per diem 737.63 per diem 737.63 per diem 528.89 per diem 784 per diem 528.89 per diem 528.89 per diem 784 per diem 2400 per diem 528.89 per diem 2200 per diem 528.89 per diem 772 per diem 737.63 per diem 750 per diem 528.89 per diem 600 per diem 750 per diem 2200 per diem 2200 per diem 528.89 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 724.69 per diem 772 per diem 448.06 per diem 772 per diem 750 per diem 700 per diem 772 per diem 750 per diem 1062.6 per diem 1000 per diem 750 per diem 700 per diem ROOM AND BOARD GERIATRIC-PSYCH 124 RC facility inpatient 2400.00 750 448.06 2400 832 per diem 774.51 per diem 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 528.89 per diem 823.14 per diem 823.14 per diem 823.14 per diem 820 per diem 1120 per diem 448.06 per diem 853 per diem 853 per diem 800 per diem 737.63 per diem 528.89 per diem 528.89 per diem 528.89 per diem 750 per diem 700 per diem 800 per diem 750 per diem 650 per diem 2200 per diem 1600 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1421 per diem 832 per diem 737.63 per diem 528.89 per diem 737.63 per diem 737.63 per diem 737.63 per diem 528.89 per diem 784 per diem 528.89 per diem 528.89 per diem 784 per diem 2400 per diem 528.89 per diem 2200 per diem 528.89 per diem 772 per diem 737.63 per diem 750 per diem 528.89 per diem 600 per diem 750 per diem 2200 per diem 2200 per diem 528.89 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 724.69 per diem 772 per diem 448.06 per diem 772 per diem 750 per diem 700 per diem 772 per diem 750 per diem 1062.6 per diem 1000 per diem 750 per diem 700 per diem ROOM AND BOARD ADOLESCENT-DETOX 126 RC facility inpatient 2400.00 750 528.89 2400 832 per diem 774.51 per diem 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 528.89 per diem 756 per diem 756 per diem 756 per diem 820 per diem 1120 per diem 853 per diem 853 per diem 800 per diem 528.89 per diem 528.89 per diem 528.89 per diem 750 per diem 700 per diem 700 per diem 750 per diem 650 per diem 2200 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1421 per diem 832 per diem 737.63 per diem 528.89 per diem 737.63 per diem 737.63 per diem 737.63 per diem 528.89 per diem 784 per diem 528.89 per diem 528.89 per diem 784 per diem 2400 per diem 528.89 per diem 2200 per diem 528.89 per diem 772 per diem 737.63 per diem 750 per diem 528.89 per diem 2200 per diem 2200 per diem 528.89 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 724.69 per diem 772 per diem 772 per diem 750 per diem 750 per diem 1062.6 per diem 1000 per diem 700 per diem ROOM AND BOARD ADULT DETOX 126 RC facility inpatient 2400.00 750 528.89 2400 832 per diem 774.51 per diem 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 528.89 per diem 756 per diem 756 per diem 756 per diem 820 per diem 1120 per diem 853 per diem 853 per diem 800 per diem 528.89 per diem 528.89 per diem 528.89 per diem 750 per diem 700 per diem 700 per diem 750 per diem 650 per diem 2200 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1421 per diem 832 per diem 737.63 per diem 528.89 per diem 737.63 per diem 737.63 per diem 737.63 per diem 528.89 per diem 784 per diem 528.89 per diem 528.89 per diem 784 per diem 2400 per diem 528.89 per diem 2200 per diem 528.89 per diem 772 per diem 737.63 per diem 750 per diem 528.89 per diem 2200 per diem 2200 per diem 528.89 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 724.69 per diem 772 per diem 772 per diem 750 per diem 750 per diem 1062.6 per diem 1000 per diem 700 per diem ROOM AND BOARD ADOLESCENT-CDRHB 128 RC facility inpatient 2400.00 750 650 2400 832 per diem 0 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 756 per diem 756 per diem 756 per diem 820 per diem 1120 per diem 853 per diem 853 per diem 800 per diem 750 per diem 700 per diem 675 per diem 750 per diem 650 per diem 2200 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1396 per diem 832 per diem 737.63 per diem 737.63 per diem 737.63 per diem 737.63 per diem 784 per diem 784 per diem 2400 per diem 2200 per diem 772 per diem 737.63 per diem 750 per diem 2200 per diem 2200 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 772 per diem 772 per diem 1062.6 per diem 1000 per diem 700 per diem ROOM AND BOARD ADULT-CD REHAB 128 RC facility inpatient 2400.00 750 650 2400 832 per diem 0 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 756 per diem 756 per diem 756 per diem 820 per diem 1120 per diem 853 per diem 853 per diem 800 per diem 750 per diem 700 per diem 675 per diem 750 per diem 650 per diem 2200 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1396 per diem 832 per diem 737.63 per diem 737.63 per diem 737.63 per diem 737.63 per diem 784 per diem 784 per diem 2400 per diem 2200 per diem 772 per diem 737.63 per diem 750 per diem 2200 per diem 2200 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 772 per diem 772 per diem 1062.6 per diem 1000 per diem 700 per diem ROOM AND BOARD CD/REHAB ADULT 128 RC facility inpatient 2400.00 750 650 2400 832 per diem 0 832 per diem 832 per diem 832 per diem 750 per diem 774.51 per diem 756 per diem 756 per diem 756 per diem 820 per diem 1120 per diem 853 per diem 853 per diem 800 per diem 750 per diem 700 per diem 675 per diem 750 per diem 650 per diem 2200 per diem 1130.5 per diem 792.95 per diem 800 per diem 781.88 per diem 775 per diem 987.7 per diem 811.4 per diem 737.63 per diem 721 per diem 1396 per diem 832 per diem 737.63 per diem 737.63 per diem 737.63 per diem 737.63 per diem 784 per diem 784 per diem 2400 per diem 2200 per diem 772 per diem 737.63 per diem 750 per diem 2200 per diem 2200 per diem 1241.35 per diem 1241.35 per diem 1192.32 per diem 1241.35 per diem 1255 per diem 772 per diem 772 per diem 1062.6 per diem 1000 per diem 700 per diem INTENSIVE OUTPATIENT PROGRAM PSYCH-ADOLESCENT 905 RC facility outpatient 600.00 150 143 600 174 per diem 175 per diem 175 per diem 220 per diem 0 180.9 per diem 209 per diem 209 per diem 300 per diem 0 0 350 per diem 250 per diem 600 per diem 175 per diem 200 per diem 143 per diem 144 per diem 170 per diem 146.7 per diem 159 per diem 146.7 per diem 180.9 per diem 225 per diem 225 per diem 600 per diem 600 per diem 205 per diem 144 per diem 205 per diem 600 per diem 600 per diem 180.9 per diem 180.9 per diem 180.9 per diem 180.9 per diem 180.9 per diem 144 per diem 205 per diem 205 per diem 205 per diem 600 per diem 180.9 per diem 325 per diem 325 per diem 206 per diem 350 per diem INTENSIVE OUTPATIENT PROGRAM PSYCH-ADULT 905 RC facility outpatient 600.00 150 143 600 174 per diem 175 per diem 175 per diem 220 per diem 0 180.9 per diem 209 per diem 209 per diem 300 per diem 0 0 350 per diem 250 per diem 600 per diem 175 per diem 200 per diem 143 per diem 144 per diem 170 per diem 146.7 per diem 159 per diem 146.7 per diem 180.9 per diem 225 per diem 225 per diem 600 per diem 600 per diem 205 per diem 144 per diem 205 per diem 600 per diem 600 per diem 180.9 per diem 180.9 per diem 180.9 per diem 180.9 per diem 180.9 per diem 144 per diem 205 per diem 205 per diem 205 per diem 600 per diem 180.9 per diem 325 per diem 325 per diem 206 per diem 350 per diem INTENSIVE OUTPATIENT PROGRAM CD GRP MCD 906 RC facility outpatient 200.00 150 144 600 174 per diem 144 per diem 144 per diem 209 per diem 209 per diem 250 per diem 600 per diem 144 per diem 144 per diem 144 per diem 0 600 per diem 144 per diem 600 per diem INTENSIVE OUTPATIENT PROGRAM CD-ADOL 906 RC facility outpatient 600.00 150 144 600 174 per diem 144 per diem 144 per diem 209 per diem 209 per diem 250 per diem 600 per diem 144 per diem 144 per diem 144 per diem 0 600 per diem 144 per diem 600 per diem INTENSIVE OUTPATIENT PROGRAM CD-ADULT 906 RC facility outpatient 600.00 150 144 600 174 per diem 144 per diem 144 per diem 209 per diem 209 per diem 250 per diem 600 per diem 144 per diem 144 per diem 144 per diem 0 600 per diem 144 per diem 600 per diem INTENSIVE OUTPATIENT PROGRAM CD PROCESS GRP 1 915 RC facility outpatient 200.00 0 143 600 144 per diem 209 per diem 209 per diem 300 per diem 600 per diem 144 per diem 143 per diem 144 per diem 144 per diem 361.8 per diem 600 per diem 144 per diem 600 per diem 600 per diem 180.9 per diem 180.9 per diem 180.9 per diem 205 per diem 205 per diem 600 per diem 180.9 per diem 425 per diem 425 per diem 206 per diem Psych Eval - Non Medical 90791 RC facility inpatient $250.00 0 87 108.39 87.00 fee schedule 108.39 fee schedule 108.39 fee schedule Psych Eval - With Medical 90792 RC facility inpatient $310.00 0 60 1125.26 88.00 fee schedule 166.52 fee schedule 174.24 fee schedule 108.12 fee schedule 89.99 fee schedule 141.54 fee schedule 66.20 fee schedule 84.84 fee schedule 1125.26 fee schedule 77.51 fee schedule 142.01 fee schedule 75.00 fee schedule 94.67 fee schedule 60.00 fee schedule 167.09 fee schedule Outpatient - Est Approx 25 Min 99214 RC facility outpatient $200.00 0 22.26 94.83 88.00 fee schedule 79.44 fee schedule 24.80 fee schedule 54.40 fee schedule 37.35 fee schedule 44.61 fee schedule 91.02 fee schedule 22.26 fee schedule 94.83 fee schedule Initial Hospital Care (70 Min) 99223 RC facility inpatient $255.00 0 49.13 153.52 116.00 fee schedule 129.00 fee schedule 113.89 fee schedule 100.43 fee schedule 153.52 fee schedule 111.10 fee schedule 49.13 fee schedule 105.00 fee schedule 105.93 fee schedule Subseq Care (15 Min) 99231 RC facility inpatient $90.00 0 19.11 47.77 27.00 fee schedule 47.77 fee schedule 23.94 fee schedule 19.11 fee schedule Subseq Care (25 Min) 99232 RC facility inpatient $115.00 0 43.06 115.97 47.84 fee schedule 75.69 fee schedule 46.42 fee schedule 43.06 fee schedule 48.43 fee schedule 56.00 fee schedule 45.93 fee schedule 56.00 fee schedule 115.97 fee schedule 98.78 fee schedule Subseq Care (35 Min) 99233 RC facility inpatient $175.00 0 43.09 103.65 56.40 fee schedule 68.56 fee schedule 103.65 fee schedule 70.83 fee schedule 57.66 fee schedule 77.44 fee schedule 96.80 fee schedule 58.54 fee schedule 58.44 fee schedule 77.13 fee schedule 72.48 fee schedule 45.36 fee schedule 85.23 fee schedule 58.09 fee schedule 43.09 fee schedule Discharge Day Mgmt <30 Min 99238 RC facility inpatient $150.00 0 41.94 95 47.25 fee schedule 76.68 fee schedule 41.94 fee schedule 47.25 fee schedule 95.00 fee schedule Discharge Day Management >30 Min 99239 RC facility inpatient $200.00 0 41.42 111.21 111.00 fee schedule 58.14 fee schedule 108.99 fee schedule 54.04 fee schedule 59.55 fee schedule 68.71 fee schedule 92.64 fee schedule 66.67 fee schedule 57.17 fee schedule 85.89 fee schedule 41.42 fee schedule 59.70 fee schedule 111.21 fee schedule