{
  "hospital_name": "Garner Behavioral Hospital, LLC",
  "last_updated_on": "2026-04-29",
  "version": "3.0.0",
  "location_name": [
    "Raleigh Oaks Behavioral Health"
  ],
  "hospital_address": [
    "3200 Waterfield Drive, Garner, NC 27529"
  ],
  "license_information": {
    "state": "NC",
    "license_number": "142"
  },
  "type_2_npi": [
    "1588319503"
  ],
  "attestation": {
    "attestation": "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 is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount.\nFor payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.",
    "confirm_attestation": true,
    "attester_name": "Lisa Evans  ( Interim)"
  },
  "standard_charge_information": [
    {
      "description": "Adult CD IOP 3 hrs",
      "code_information": [
        {
          "code": "H0015",
          "type": "HCPCS"
        },
        {
          "code": "961",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 242.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 240.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "minimum": 235.0,
          "maximum": 242.0
        }
      ]
    },
    {
      "description": "Gero CD IOP 3 hrs",
      "code_information": [
        {
          "code": "H0015",
          "type": "HCPCS"
        },
        {
          "code": "951",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 242.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 240.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "minimum": 235.0,
          "maximum": 242.0
        }
      ]
    },
    {
      "description": "Gero Psych IOP 3 hrs",
      "code_information": [
        {
          "code": "90853",
          "type": "CPT"
        },
        {
          "code": "946",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 242.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 240.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "minimum": 235.0,
          "maximum": 242.0
        }
      ]
    },
    {
      "description": "PHP CD Adult Daily",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        },
        {
          "code": "928",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 464.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "minimum": 450.0,
          "maximum": 464.0
        }
      ]
    },
    {
      "description": "PHP CD Gero Daily",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        },
        {
          "code": "916",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 464.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "minimum": 450.0,
          "maximum": 464.0
        }
      ]
    },
    {
      "description": "Acute Psych Adol R&B",
      "code_information": [
        {
          "code": "124",
          "type": "RC"
        },
        {
          "code": "902",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "inpatient",
          "payers_information": [
            {
              "payer_name": "Ambetter",
              "plan_name": "Ambetter",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "CIGNA HEALTHCARE",
              "plan_name": "CIGNA HEALTHCARE",
              "standard_charge_dollar": 1080.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Partners Behavioral Health Management",
              "plan_name": "Partners Behavioral Health Management",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 3000.0,
          "minimum": 800.0,
          "maximum": 1080.0
        }
      ]
    },
    {
      "description": "Acute Psych Adult R&B",
      "code_information": [
        {
          "code": "124",
          "type": "RC"
        },
        {
          "code": "901",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "inpatient",
          "payers_information": [
            {
              "payer_name": "AARP Medicare Advantage Plan",
              "plan_name": "AARP Medicare Advantage Plan",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 1046.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Aetna Better Health Of Virginia Medicaid",
              "plan_name": "Aetna Better Health Of Virginia Medicaid",
              "standard_charge_dollar": 600.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Aetna Medicare Advantage Plan",
              "plan_name": "Aetna Medicare Advantage Plan",
              "standard_charge_dollar": 1044.99,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Alignment Health Plan Of North Carolina",
              "plan_name": "Alignment Health Plan Of North Carolina",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "All Savers",
              "plan_name": "All Savers",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Alliance (Commercial Policy) IPRS",
              "plan_name": "Alliance (Commercial Policy) IPRS",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Alliance Behavioral Health",
              "plan_name": "Alliance Behavioral Health",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Allied Benefit Systems",
              "plan_name": "Allied Benefit Systems",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Ambetter",
              "plan_name": "Ambetter",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "AmeriHealth Caritas Of NC Medicaid",
              "plan_name": "AmeriHealth Caritas Of NC Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Anthem Empire - New York Medicaid",
              "plan_name": "Anthem Empire - New York Medicaid",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBS IL Medicaid",
              "plan_name": "BCBS IL Medicaid",
              "standard_charge_dollar": 600.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBS STATE HEALTH PLAN",
              "plan_name": "BCBS STATE HEALTH PLAN",
              "standard_charge_dollar": 890.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBSNC",
              "plan_name": "BCBSNC",
              "standard_charge_dollar": 908.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Blue Medicare Advantage Plan",
              "plan_name": "Blue Medicare Advantage Plan",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Bright Health",
              "plan_name": "Bright Health",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 1000.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carolina Complete Health Medicaid",
              "plan_name": "Carolina Complete Health Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Cigna Behavioral Health",
              "plan_name": "Cigna Behavioral Health",
              "standard_charge_dollar": 1080.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "CIGNA HEALTHCARE",
              "plan_name": "CIGNA HEALTHCARE",
              "standard_charge_dollar": 1080.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Cigna Healthspring",
              "plan_name": "Cigna Healthspring",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "CIHA Cherokee Indian Hospital",
              "plan_name": "CIHA Cherokee Indian Hospital",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Eastpointe Human Services",
              "plan_name": "Eastpointe Human Services",
              "standard_charge_dollar": 823.98,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Financial Hardship/Charity",
              "plan_name": "Financial Hardship/Charity",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Golden Rule A United Healthcare Company",
              "plan_name": "Golden Rule A United Healthcare Company",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Health Alliance",
              "plan_name": "Health Alliance",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Health Choice",
              "plan_name": "Health Choice",
              "standard_charge_dollar": 473.23,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Healthfirst - New York Medicaid",
              "plan_name": "Healthfirst - New York Medicaid",
              "standard_charge_dollar": 600.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Healthgram",
              "plan_name": "Healthgram",
              "standard_charge_dollar": 1200.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Healthy Blue BCBS Medicaid",
              "plan_name": "Healthy Blue BCBS Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Humana",
              "plan_name": "Humana",
              "standard_charge_dollar": 1150.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "IPRS - Vaya (Only Use For IPRS)",
              "plan_name": "IPRS - Vaya (Only Use For IPRS)",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Kaiser Permantente",
              "plan_name": "Kaiser Permantente",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "MedCost",
              "plan_name": "MedCost",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Medica Health Plan Solutins",
              "plan_name": "Medica Health Plan Solutins",
              "standard_charge_dollar": 900.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 985.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "New Jersey Medicaid",
              "plan_name": "New Jersey Medicaid",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Optima Health VA Medicaid",
              "plan_name": "Optima Health VA Medicaid",
              "standard_charge_dollar": 823.98,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Optum Health/United Health",
              "plan_name": "Optum Health/United Health",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "PA Medicaid - Keystone First",
              "plan_name": "PA Medicaid - Keystone First",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Partners Behavioral Health Management",
              "plan_name": "Partners Behavioral Health Management",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Pennsylvania Health & Wellness Medicaid",
              "plan_name": "Pennsylvania Health & Wellness Medicaid",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "PHCS",
              "plan_name": "PHCS",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Sandhills Center",
              "plan_name": "Sandhills Center",
              "standard_charge_dollar": 823.98,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "State Health Plan - BCBS",
              "plan_name": "State Health Plan - BCBS",
              "standard_charge_dollar": 1200.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Superior Health Medicare - TX Dual",
              "plan_name": "Superior Health Medicare - TX Dual",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Surest",
              "plan_name": "Surest",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "TN Medicaid - Amerigroup",
              "plan_name": "TN Medicaid - Amerigroup",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Tricare East Region Claims",
              "plan_name": "Tricare East Region Claims",
              "standard_charge_dollar": 940.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Tricare For Life",
              "plan_name": "Tricare For Life",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Trillium Health Resources",
              "plan_name": "Trillium Health Resources",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Community Plan Medicaid",
              "plan_name": "UHC Community Plan Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "UHC Medicare Advantage Plan",
              "standard_charge_dollar": 1000.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UMR",
              "plan_name": "UMR",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Behavioral Health",
              "plan_name": "United Behavioral Health",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare",
              "plan_name": "United Healthcare",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare Community Plan",
              "plan_name": "United Healthcare Community Plan",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare Shared Services",
              "plan_name": "United Healthcare Shared Services",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UPMC",
              "plan_name": "UPMC",
              "standard_charge_dollar": 1080.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Vaya Health",
              "plan_name": "Vaya Health",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Virginia Medicaid",
              "plan_name": "Virginia Medicaid",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Virginia Medicaid - Anthem",
              "plan_name": "Virginia Medicaid - Anthem",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Washington Medicaid - UHC",
              "plan_name": "Washington Medicaid - UHC",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Wellcare Of NC Medicaid",
              "plan_name": "Wellcare Of NC Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 3000.0,
          "discounted_cash": 800.0,
          "minimum": 473.23,
          "maximum": 1200.0
        }
      ]
    },
    {
      "description": "Acute Psych Gero R&B",
      "code_information": [
        {
          "code": "124",
          "type": "RC"
        },
        {
          "code": "900",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "inpatient",
          "payers_information": [
            {
              "payer_name": "AARP Medicare Advantage Plan",
              "plan_name": "AARP Medicare Advantage Plan",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "ACS Benefit Services",
              "plan_name": "ACS Benefit Services",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 1046.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Aetna Better Health Of Virginia Medicaid",
              "plan_name": "Aetna Better Health Of Virginia Medicaid",
              "standard_charge_dollar": 600.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Aetna Medicare Advantage Plan",
              "plan_name": "Aetna Medicare Advantage Plan",
              "standard_charge_dollar": 985.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Alignment Health Plan Of North Carolina",
              "plan_name": "Alignment Health Plan Of North Carolina",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "All Savers",
              "plan_name": "All Savers",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Alliance Behavioral Health",
              "plan_name": "Alliance Behavioral Health",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Allied Benefit Systems",
              "plan_name": "Allied Benefit Systems",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Ambetter",
              "plan_name": "Ambetter",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "AmeriHealth Caritas Of NC Medicaid",
              "plan_name": "AmeriHealth Caritas Of NC Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Anthem Empire - New York Medicaid",
              "plan_name": "Anthem Empire - New York Medicaid",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBS IL Medicaid",
              "plan_name": "BCBS IL Medicaid",
              "standard_charge_dollar": 600.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBSNC",
              "plan_name": "BCBSNC",
              "standard_charge_dollar": 908.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Blue Medicare Advantage Plan",
              "plan_name": "Blue Medicare Advantage Plan",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Bright Health",
              "plan_name": "Bright Health",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 1000.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carolina Complete Health Medicaid",
              "plan_name": "Carolina Complete Health Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Cigna Behavioral Health",
              "plan_name": "Cigna Behavioral Health",
              "standard_charge_dollar": 1080.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "CIGNA HEALTHCARE",
              "plan_name": "CIGNA HEALTHCARE",
              "standard_charge_dollar": 1080.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Cigna Healthspring",
              "plan_name": "Cigna Healthspring",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "CIHA Cherokee Indian Hospital",
              "plan_name": "CIHA Cherokee Indian Hospital",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Eastpointe Human Services",
              "plan_name": "Eastpointe Human Services",
              "standard_charge_dollar": 823.98,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Financial Hardship/Charity",
              "plan_name": "Financial Hardship/Charity",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "GEHA Government Employee Health",
              "plan_name": "GEHA Government Employee Health",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Golden Rule A United Healthcare Company",
              "plan_name": "Golden Rule A United Healthcare Company",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Health Alliance",
              "plan_name": "Health Alliance",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Health Choice",
              "plan_name": "Health Choice",
              "standard_charge_dollar": 473.23,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Healthfirst - New York Medicaid",
              "plan_name": "Healthfirst - New York Medicaid",
              "standard_charge_dollar": 600.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Healthgram",
              "plan_name": "Healthgram",
              "standard_charge_dollar": 1200.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Healthy Blue BCBS Medicaid",
              "plan_name": "Healthy Blue BCBS Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Humana",
              "plan_name": "Humana",
              "standard_charge_dollar": 1150.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "IPRS - Vaya (Only Use For IPRS)",
              "plan_name": "IPRS - Vaya (Only Use For IPRS)",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "MedCost",
              "plan_name": "MedCost",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 985.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "New Jersey Medicaid",
              "plan_name": "New Jersey Medicaid",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Optum Health/United Health",
              "plan_name": "Optum Health/United Health",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "PA Medicaid - Keystone First",
              "plan_name": "PA Medicaid - Keystone First",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Partners Behavioral Health Management",
              "plan_name": "Partners Behavioral Health Management",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Pennsylvania Health & Wellness Medicaid",
              "plan_name": "Pennsylvania Health & Wellness Medicaid",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "PHCS",
              "plan_name": "PHCS",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Sandhills Center",
              "plan_name": "Sandhills Center",
              "standard_charge_dollar": 823.98,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "State Health Plan - BCBS",
              "plan_name": "State Health Plan - BCBS",
              "standard_charge_dollar": 1200.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Superior Health Medicare - TX Dual",
              "plan_name": "Superior Health Medicare - TX Dual",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "TN Medicaid - Amerigroup",
              "plan_name": "TN Medicaid - Amerigroup",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Tricare East Region Claims",
              "plan_name": "Tricare East Region Claims",
              "standard_charge_dollar": 940.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Tricare For Life",
              "plan_name": "Tricare For Life",
              "standard_charge_dollar": 800.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Trillium Health Resources",
              "plan_name": "Trillium Health Resources",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Community Plan Medicaid",
              "plan_name": "UHC Community Plan Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "UHC Medicare Advantage Plan",
              "standard_charge_dollar": 1000.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UMR",
              "plan_name": "UMR",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Behavioral Health",
              "plan_name": "United Behavioral Health",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare",
              "plan_name": "United Healthcare",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare Community Plan",
              "plan_name": "United Healthcare Community Plan",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare Shared Services",
              "plan_name": "United Healthcare Shared Services",
              "standard_charge_dollar": 1050.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UPMC",
              "plan_name": "UPMC",
              "standard_charge_dollar": 1080.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Vaya Health",
              "plan_name": "Vaya Health",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Virginia Medicaid",
              "plan_name": "Virginia Medicaid",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Virginia Medicaid - Anthem",
              "plan_name": "Virginia Medicaid - Anthem",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Washington Medicaid - UHC",
              "plan_name": "Washington Medicaid - UHC",
              "standard_charge_dollar": 500.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Wellcare Of NC Medicaid",
              "plan_name": "Wellcare Of NC Medicaid",
              "standard_charge_dollar": 895.63,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 3000.0,
          "discounted_cash": 800.0,
          "minimum": 473.23,
          "maximum": 1200.0
        }
      ]
    },
    {
      "description": "Adult Psych IOP 3 Hrs",
      "code_information": [
        {
          "code": "90853",
          "type": "CPT"
        },
        {
          "code": "956",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 242.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Alignment Health Plan Of North Carolina",
              "plan_name": "Alignment Health Plan Of North Carolina",
              "standard_charge_dollar": 200.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Alliance Behavioral Health",
              "plan_name": "Alliance Behavioral Health",
              "standard_charge_dollar": 250.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Ambetter",
              "plan_name": "Ambetter",
              "standard_charge_dollar": 250.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "AmeriHealth Caritas Of NC Medicaid",
              "plan_name": "AmeriHealth Caritas Of NC Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBSNC",
              "plan_name": "BCBSNC",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 240.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carolina Complete Health Medicaid",
              "plan_name": "Carolina Complete Health Medicaid",
              "standard_charge_dollar": 150.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "CIGNA HEALTHCARE",
              "plan_name": "CIGNA HEALTHCARE",
              "standard_charge_dollar": 150.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Financial Hardship/Charity",
              "plan_name": "Financial Hardship/Charity",
              "standard_charge_dollar": 200.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Golden Rule A United Healthcare Company",
              "plan_name": "Golden Rule A United Healthcare Company",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Healthy Blue BCBS Medicaid",
              "plan_name": "Healthy Blue BCBS Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Humana Medicare-DRG-HMO/PPO",
              "plan_name": "Humana Medicare-DRG-HMO/PPO",
              "standard_charge_dollar": 250.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Optum Health/United Health",
              "plan_name": "Optum Health/United Health",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "State Health Plan - BCBS",
              "plan_name": "State Health Plan - BCBS",
              "standard_charge_dollar": 240.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Tricare East Region Claims",
              "plan_name": "Tricare East Region Claims",
              "standard_charge_dollar": 325.8,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Troy Health, INC Medicare Advantage",
              "plan_name": "Troy Health, INC Medicare Advantage",
              "standard_charge_dollar": 300.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Community Plan Medicaid",
              "plan_name": "UHC Community Plan Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Dual SNP",
              "plan_name": "UHC Dual SNP",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "UHC Medicare Advantage Plan",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UMR",
              "plan_name": "UMR",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Behavioral Health",
              "plan_name": "United Behavioral Health",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare",
              "plan_name": "United Healthcare",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare Community Plan",
              "plan_name": "United Healthcare Community Plan",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare Shared Services",
              "plan_name": "United Healthcare Shared Services",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Wellcare Of NC Medicaid",
              "plan_name": "Wellcare Of NC Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 1700.0,
          "minimum": 150.0,
          "maximum": 325.8
        }
      ]
    },
    {
      "description": "IOP Adult Daily Rate",
      "code_information": [
        {
          "code": "S9480",
          "type": "HCPCS"
        },
        {
          "code": "53000",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 242.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBSNC",
              "plan_name": "BCBSNC",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Cigna Behavioral Health",
              "plan_name": "Cigna Behavioral Health",
              "standard_charge_dollar": 150.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "CIGNA HEALTHCARE",
              "plan_name": "CIGNA HEALTHCARE",
              "standard_charge_dollar": 150.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Tricare East Region Claims",
              "plan_name": "Tricare East Region Claims",
              "standard_charge_dollar": 328.5,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 1700.0,
          "minimum": 150.0,
          "maximum": 328.5
        }
      ]
    },
    {
      "description": "Telehealth Adult IOP 3 hrs",
      "code_information": [
        {
          "code": "H0015",
          "type": "HCPCS"
        },
        {
          "code": "820",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Alliance Behavioral Health",
              "plan_name": "Alliance Behavioral Health",
              "standard_charge_dollar": 250.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Ambetter",
              "plan_name": "Ambetter",
              "standard_charge_dollar": 250.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "AmeriHealth Caritas Of NC Medicaid",
              "plan_name": "AmeriHealth Caritas Of NC Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBSNC",
              "plan_name": "BCBSNC",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 240.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carolina Complete Health Medicaid",
              "plan_name": "Carolina Complete Health Medicaid",
              "standard_charge_dollar": 150.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "CIGNA HEALTHCARE",
              "plan_name": "CIGNA HEALTHCARE",
              "standard_charge_dollar": 150.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Healthy Blue BCBS Medicaid",
              "plan_name": "Healthy Blue BCBS Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Humana Medicare-DRG-HMO/PPO",
              "plan_name": "Humana Medicare-DRG-HMO/PPO",
              "standard_charge_dollar": 250.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Optum Health/United Health",
              "plan_name": "Optum Health/United Health",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Tricare East Region Claims",
              "plan_name": "Tricare East Region Claims",
              "standard_charge_dollar": 325.8,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Community Plan Medicaid",
              "plan_name": "UHC Community Plan Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Dual SNP",
              "plan_name": "UHC Dual SNP",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "UHC Medicare Advantage Plan",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Wellcare Of NC Medicaid",
              "plan_name": "Wellcare Of NC Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 1700.0,
          "minimum": 150.0,
          "maximum": 325.8
        }
      ]
    },
    {
      "description": "PHP Daily Adult",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        },
        {
          "code": "1010",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "Troy Health, INC Medicare Advantage",
              "plan_name": "Troy Health, INC Medicare Advantage",
              "standard_charge_dollar": 400.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 2500.0,
          "minimum": 400.0,
          "maximum": 400.0
        }
      ]
    },
    {
      "description": "PHP Psych Adult Daily",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        },
        {
          "code": "922",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 464.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBSNC",
              "plan_name": "BCBSNC",
              "standard_charge_dollar": 459.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Golden Rule A United Healthcare Company",
              "plan_name": "Golden Rule A United Healthcare Company",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Optum Health/United Health",
              "plan_name": "Optum Health/United Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "State Health Plan - BCBS",
              "plan_name": "State Health Plan - BCBS",
              "standard_charge_dollar": 520.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "UHC Medicare Advantage Plan",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UMR",
              "plan_name": "UMR",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Behavioral Health",
              "plan_name": "United Behavioral Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare",
              "plan_name": "United Healthcare",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare Community Plan",
              "plan_name": "United Healthcare Community Plan",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "United Healthcare Shared Services",
              "plan_name": "United Healthcare Shared Services",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 2500.0,
          "minimum": 450.0,
          "maximum": 520.0
        }
      ]
    },
    {
      "description": "PHP Psych Gero Daily",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        },
        {
          "code": "910",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AETNA",
              "plan_name": "AETNA",
              "standard_charge_dollar": 464.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "Carelon Behavioral Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Meritain Health",
              "plan_name": "Meritain Health",
              "standard_charge_dollar": 450.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 2500.0,
          "minimum": 450.0,
          "maximum": 464.0
        }
      ]
    },
    {
      "description": "MCR IOP Adult- 3 units",
      "code_information": [
        {
          "code": "90853",
          "type": "CPT"
        },
        {
          "code": "52003",
          "type": "LOCAL"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "payers_information": [
            {
              "payer_name": "AmeriHealth Caritas Of NC Medicaid",
              "plan_name": "AmeriHealth Caritas Of NC Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "BCBSNC",
              "plan_name": "BCBSNC",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Humana Medicare-DRG-HMO/PPO",
              "plan_name": "Humana Medicare-DRG-HMO/PPO",
              "standard_charge_dollar": 250.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "UHC Medicare Advantage Plan",
              "standard_charge_dollar": 245.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            },
            {
              "payer_name": "Wellcare Of NC Medicaid",
              "plan_name": "Wellcare Of NC Medicaid",
              "standard_charge_dollar": 235.0,
              "methodology": "fee schedule",
              "additional_payer_notes": ""
            }
          ],
          "gross_charge": 566.67,
          "minimum": 235.0,
          "maximum": 250.0
        }
      ]
    }
  ]
}