{
  "hospital_name": "SBH-Madison, LLC",
  "location_name": [
    "SBH-Madison, LLC"
  ],
  "hospital_address": [
    "3169 Deming Way, Middleton, WI 53562"
  ],
  "type_2_npi": [
    "1003413816"
  ],
  "license_information": {
    "license_number": "3535",
    "state": "WI"
  },
  "last_updated_on": "2026-03-31",
  "version": "3.0",
  "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. For 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": "Ricky Ament"
  },
  "standard_charge_information": [
    {
      "description": "Adult Psych PHP 6 hrs",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 500.0,
          "discounted_cash_price": 500.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "HealthPartners",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            }
          ],
          "minimum": 500.0,
          "maximum": 500.0
        }
      ]
    },
    {
      "description": "Telehealth Adult Psych IOP 3 hrs",
      "code_information": [
        {
          "code": "90853",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1190.0,
          "discounted_cash_price": 1190.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Anthem Commercial- HMO/PPO",
              "plan_name": "All Plans",
              "negotiated_rate": 210.0
            },
            {
              "payer_name": "Anthem Commerical- Blue Priority",
              "plan_name": "All Plans",
              "negotiated_rate": 210.0
            },
            {
              "payer_name": "Anthem Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Anthem Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Chorus Childrens Community Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Cigna Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "Dean Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 261.32
            },
            {
              "payer_name": "Dean Health-Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Group Health EauClaire Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "HealthPartners",
              "plan_name": "All Plans",
              "negotiated_rate": 325.0
            },
            {
              "payer_name": "Humana Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "ICare Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "ICare Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 175.0
            },
            {
              "payer_name": "Managed Health Services-Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Molina Healthcare Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "My Choice-Care WI Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Network Health HMO",
              "plan_name": "All Plans",
              "negotiated_rate": 225.23
            },
            {
              "payer_name": "Network Health PPO",
              "plan_name": "All Plans",
              "negotiated_rate": 1190.0
            },
            {
              "payer_name": "Quartz Align - Brighton Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 350.0
            },
            {
              "payer_name": "Quartz Commercial Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 350.0
            },
            {
              "payer_name": "Quartz Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Security Health Plan Managed Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Surest",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "TRICARE EAST-WPS",
              "plan_name": "All Plans",
              "negotiated_rate": 249.1
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "UHC Medicare Dual Complete",
              "plan_name": "All Plans",
              "negotiated_rate": 150.0
            },
            {
              "payer_name": "UHC Shared Services",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "UMR Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "United Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "United Healthcare Medicaid Community Pla",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Wellcare By Allwell",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            }
          ],
          "minimum": 150.0,
          "maximum": 1190.0
        }
      ]
    },
    {
      "description": "Telehealth PHP Psych Adult Daily",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 550.0,
          "discounted_cash_price": 550.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Quartz Align - Brighton Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            },
            {
              "payer_name": "Quartz Commercial Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            }
          ],
          "minimum": 550.0,
          "maximum": 550.0
        }
      ]
    },
    {
      "description": "Telehealth PHP Psych Child/Adol Daily",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 550.0,
          "discounted_cash_price": 550.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Quartz Align - Brighton Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            },
            {
              "payer_name": "Quartz Commercial Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            }
          ],
          "minimum": 550.0,
          "maximum": 550.0
        }
      ]
    },
    {
      "description": "Telehealth PHP CD Adult Daily",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 550.0,
          "discounted_cash_price": 550.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Quartz Align - Brighton Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            },
            {
              "payer_name": "Quartz Commercial Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            }
          ],
          "minimum": 550.0,
          "maximum": 550.0
        }
      ]
    },
    {
      "description": "Adult Psych IOP 3 Hrs",
      "code_information": [
        {
          "code": "90853",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 847.57,
          "discounted_cash_price": 847.57,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Quartz Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Surest",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "UHC Shared Services",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "United Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "Wellcare By Allwell",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            }
          ],
          "minimum": 275.0,
          "maximum": 847.57
        }
      ]
    },
    {
      "description": "PHP Daily Adult",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1750.0,
          "discounted_cash_price": 350.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Administrative Concepts Inc",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "Aetna",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "Aetna Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 1435.0
            },
            {
              "payer_name": "Anthem Commercial- HMO/PPO",
              "plan_name": "All Plans",
              "negotiated_rate": 315.0
            },
            {
              "payer_name": "Anthem Commerical- Blue Priority",
              "plan_name": "All Plans",
              "negotiated_rate": 299.0
            },
            {
              "payer_name": "Anthem Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Anthem Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 350.0
            },
            {
              "payer_name": "Aspirus Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 1435.0
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "All Plans",
              "negotiated_rate": 430.0
            },
            {
              "payer_name": "Chorus Childrens Community Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Cigna Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 475.0
            },
            {
              "payer_name": "Dean Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 442.24
            },
            {
              "payer_name": "Dean Health-Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Dean Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 300.0
            },
            {
              "payer_name": "Group Health South Commerical",
              "plan_name": "All Plans",
              "negotiated_rate": 525.0
            },
            {
              "payer_name": "Group Health South Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Health EOS - Multiplan",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "HealthPartners",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "Humana Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 915.0
            },
            {
              "payer_name": "ICare Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "ICare Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 268.79
            },
            {
              "payer_name": "Iowa Medicaid - Amerigroup",
              "plan_name": "All Plans",
              "negotiated_rate": 395.0
            },
            {
              "payer_name": "Magellan Behavioral Health",
              "plan_name": "All Plans",
              "negotiated_rate": 450.0
            },
            {
              "payer_name": "Managed Health Services Medicare Advanta",
              "plan_name": "All Plans",
              "negotiated_rate": 300.0
            },
            {
              "payer_name": "Managed Health Services-Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "MEDICA - SSM HEALTH DEAN EHP",
              "plan_name": "All Plans",
              "negotiated_rate": 400.0
            },
            {
              "payer_name": "Mercy Care Wi Medicaid MCO",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "MercyCare Commerical",
              "plan_name": "All Plans",
              "negotiated_rate": 454.75
            },
            {
              "payer_name": "Molina Healthcare Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 325.0
            },
            {
              "payer_name": "Molina Healthcare Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "My Choice -Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 90.1
            },
            {
              "payer_name": "My Choice-Care WI Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "My Choice-Trilogy Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 91.5
            },
            {
              "payer_name": "Network Health HMO",
              "plan_name": "All Plans",
              "negotiated_rate": 337.85
            },
            {
              "payer_name": "Network Health Medicaid Managed",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Network Health PPO",
              "plan_name": "All Plans",
              "negotiated_rate": 1750.0
            },
            {
              "payer_name": "Physicians Mutual",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "Prairie States Enterprises INC",
              "plan_name": "All Plans",
              "negotiated_rate": 299.0
            },
            {
              "payer_name": "Preferred One Admin Services",
              "plan_name": "All Plans",
              "negotiated_rate": 315.0
            },
            {
              "payer_name": "Quartz Align - Brighton Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            },
            {
              "payer_name": "Quartz Commercial Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            },
            {
              "payer_name": "Quartz Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Quartz Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 350.0
            },
            {
              "payer_name": "RAS Workers Comp",
              "plan_name": "All Plans",
              "negotiated_rate": 43.75
            },
            {
              "payer_name": "Security Health Medicare Advantage",
              "plan_name": "All Plans",
              "negotiated_rate": 300.0
            },
            {
              "payer_name": "Security Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 463.5
            },
            {
              "payer_name": "Security Health Plan Managed Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Sharp Health Plan HMO",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "Surest",
              "plan_name": "All Plans",
              "negotiated_rate": 400.0
            },
            {
              "payer_name": "The Alliance Auxiant",
              "plan_name": "All Plans",
              "negotiated_rate": 450.0
            },
            {
              "payer_name": "TRICARE EAST-WPS",
              "plan_name": "All Plans",
              "negotiated_rate": 268.79
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "UHC Medicare Dual Complete",
              "plan_name": "All Plans",
              "negotiated_rate": 300.0
            },
            {
              "payer_name": "UHC Shared Services",
              "plan_name": "All Plans",
              "negotiated_rate": 300.0
            },
            {
              "payer_name": "UHC/OPTUM",
              "plan_name": "All Plans",
              "negotiated_rate": 400.0
            },
            {
              "payer_name": "UMR Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 400.0
            },
            {
              "payer_name": "United Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 400.0
            },
            {
              "payer_name": "United Healthcare Medicaid Community Pla",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "WEA Trust Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 425.0
            },
            {
              "payer_name": "Wellcare By Allwell",
              "plan_name": "All Plans",
              "negotiated_rate": 400.0
            }
          ],
          "minimum": 43.75,
          "maximum": 1750.0
        }
      ]
    },
    {
      "description": "Tri/Medi Adult PHP - 5 unit",
      "code_information": [
        {
          "code": "G0411",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 350.0,
          "discounted_cash_price": 350.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Anthem Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 350.0
            }
          ],
          "minimum": 350.0,
          "maximum": 350.0
        }
      ]
    },
    {
      "description": "PHP Daily Gero",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1750.0,
          "discounted_cash_price": 1750.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Aetna Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 1435.0
            },
            {
              "payer_name": "Aspirus Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 1435.0
            },
            {
              "payer_name": "Chorus Childrens Community Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Cigna Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 475.0
            },
            {
              "payer_name": "Dean Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 442.24
            },
            {
              "payer_name": "Health EOS - Multiplan",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "Managed Health Services-Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "MercyCare Commerical",
              "plan_name": "All Plans",
              "negotiated_rate": 454.75
            },
            {
              "payer_name": "Network Health HMO",
              "plan_name": "All Plans",
              "negotiated_rate": 337.85
            },
            {
              "payer_name": "Network Health PPO",
              "plan_name": "All Plans",
              "negotiated_rate": 1750.0
            },
            {
              "payer_name": "Quartz Align - Brighton Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            },
            {
              "payer_name": "Quartz Commercial Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 550.0
            },
            {
              "payer_name": "WEA Trust Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 425.0
            }
          ],
          "minimum": 337.85,
          "maximum": 1750.0
        }
      ]
    },
    {
      "description": "Gero IOP 3 hrs",
      "code_information": [
        {
          "code": "90853",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 980.0,
          "discounted_cash_price": 980.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Aetna Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 980.0
            },
            {
              "payer_name": "Aspirus Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 980.0
            },
            {
              "payer_name": "Chorus Childrens Community Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Cigna Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "Health EOS - Multiplan",
              "plan_name": "All Plans",
              "negotiated_rate": 300.0
            },
            {
              "payer_name": "MercyCare Commerical",
              "plan_name": "All Plans",
              "negotiated_rate": 240.75
            },
            {
              "payer_name": "WEA Trust Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 225.0
            }
          ],
          "minimum": 225.0,
          "maximum": 980.0
        }
      ]
    },
    {
      "description": "Adult Psych IOP 3 Hrs",
      "code_information": [
        {
          "code": "90853",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1190.0,
          "discounted_cash_price": 200.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "AARP Medicare Complete",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "Administrative Concepts Inc",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Aetna",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Aetna Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 980.0
            },
            {
              "payer_name": "Allegiance Benefit Plan Management",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "Anthem Commercial- HMO/PPO",
              "plan_name": "All Plans",
              "negotiated_rate": 210.0
            },
            {
              "payer_name": "Anthem Commerical- Blue Priority",
              "plan_name": "All Plans",
              "negotiated_rate": 210.0
            },
            {
              "payer_name": "Anthem Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Anthem Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Aspirus Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 980.0
            },
            {
              "payer_name": "Aspirus Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Carelon Behavioral Health",
              "plan_name": "All Plans",
              "negotiated_rate": 225.0
            },
            {
              "payer_name": "Cigna Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "Dean Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 261.32
            },
            {
              "payer_name": "Dean Health-Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Dean Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Group Health South Commerical",
              "plan_name": "All Plans",
              "negotiated_rate": 225.0
            },
            {
              "payer_name": "Group Health South Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Health EOS - Multiplan",
              "plan_name": "All Plans",
              "negotiated_rate": 300.0
            },
            {
              "payer_name": "HealthPartners",
              "plan_name": "All Plans",
              "negotiated_rate": 325.0
            },
            {
              "payer_name": "Humana Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "ICare Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "ICare Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 175.0
            },
            {
              "payer_name": "Lutheran Social Services Of WI And UP",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Magellan Behavioral Health",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "Managed Health Services Medicare Advanta",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "Managed Health Services-Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "MEDICA - SSM HEALTH DEAN EHP",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "Mercy Care Wi Medicaid MCO",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "MercyCare Commerical",
              "plan_name": "All Plans",
              "negotiated_rate": 240.75
            },
            {
              "payer_name": "Molina Healthcare Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 170.0
            },
            {
              "payer_name": "Molina Healthcare Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "My Choice -Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 55.22
            },
            {
              "payer_name": "My Choice-Care WI Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Network Health HMO",
              "plan_name": "All Plans",
              "negotiated_rate": 225.23
            },
            {
              "payer_name": "Network Health Medicaid Managed",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Network Health PPO",
              "plan_name": "All Plans",
              "negotiated_rate": 1190.0
            },
            {
              "payer_name": "Preferred One Admin Services",
              "plan_name": "All Plans",
              "negotiated_rate": 212.0
            },
            {
              "payer_name": "Quartz Align - Brighton Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 350.0
            },
            {
              "payer_name": "Quartz Commercial Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 350.0
            },
            {
              "payer_name": "Quartz Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "Quartz Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Security Health Medicare Advantage",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Security Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 283.25
            },
            {
              "payer_name": "Sharp Health Plan HMO",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "Surest",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "The Alliance Auxiant",
              "plan_name": "All Plans",
              "negotiated_rate": 250.0
            },
            {
              "payer_name": "Tricare West",
              "plan_name": "All Plans",
              "negotiated_rate": 321.1
            },
            {
              "payer_name": "UHC Medicare Advantage Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 200.0
            },
            {
              "payer_name": "UHC Shared Services",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "UHC/OPTUM",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "UMR Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "United Healthcare",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            },
            {
              "payer_name": "United Healthcare Medicaid Community Pla",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "WEA Trust Commercial",
              "plan_name": "All Plans",
              "negotiated_rate": 225.0
            },
            {
              "payer_name": "Wellcare By Allwell",
              "plan_name": "All Plans",
              "negotiated_rate": 275.0
            }
          ],
          "minimum": 55.22,
          "maximum": 1190.0
        }
      ]
    },
    {
      "description": "Tri/Medi Adult IOP-3 unit",
      "code_information": [
        {
          "code": "90853",
          "type": "CPT"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 847.57,
          "discounted_cash_price": 847.57,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Dean Health-Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 112.98
            },
            {
              "payer_name": "ICare Medicare",
              "plan_name": "All Plans",
              "negotiated_rate": 175.0
            },
            {
              "payer_name": "Quartz Medicaid",
              "plan_name": "All Plans",
              "negotiated_rate": 847.57
            },
            {
              "payer_name": "TRICARE EAST-WPS",
              "plan_name": "All Plans",
              "negotiated_rate": 249.1
            },
            {
              "payer_name": "Tricare West",
              "plan_name": "All Plans",
              "negotiated_rate": 321.1
            }
          ],
          "minimum": 112.98,
          "maximum": 847.57
        }
      ]
    },
    {
      "description": "PHP Daily Adult",
      "code_information": [
        {
          "code": "H0035",
          "type": "HCPCS"
        }
      ],
      "standard_charges": [
        {
          "setting": "outpatient",
          "gross_charge": 1750.0,
          "discounted_cash_price": 1750.0,
          "payer_specific_negotiated_charges": [
            {
              "payer_name": "Dean Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 442.24
            },
            {
              "payer_name": "Group Health South Commerical",
              "plan_name": "All Plans",
              "negotiated_rate": 525.0
            },
            {
              "payer_name": "HealthPartners",
              "plan_name": "All Plans",
              "negotiated_rate": 500.0
            },
            {
              "payer_name": "Network Health HMO",
              "plan_name": "All Plans",
              "negotiated_rate": 337.85
            },
            {
              "payer_name": "Network Health PPO",
              "plan_name": "All Plans",
              "negotiated_rate": 1750.0
            },
            {
              "payer_name": "Security Health Plan",
              "plan_name": "All Plans",
              "negotiated_rate": 463.5
            }
          ],
          "minimum": 337.85,
          "maximum": 1750.0
        }
      ]
    }
  ]
}