Hospital

WELLBRIDGE HEALTHCARE FORT WORTH

Fort Worth, TX · CCN 454128 · Rates published

123 distinct procedures filed

111 distinct payers

1,116 rate rows

2026-08-17 last MRF observed

Data quality

830 of 1,116 rate rows are consumer-grade (74.4%)

286 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
per-diem day rate — not a per-procedure price	146
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	140

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.wellbridgefortworth.com/docs/bhwellbridgefortworthlibraries/3q26/85-0520285_wellbridge-healthcare-fort-worth_standardcharges.csv
Found on page	https://www.wellbridgefortworth.com/resources/accepted-insurance/#price-list
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-09-16
Content fingerprint	d486bdcb4486c6b1… · 480,818 bytes · first seen 2026-08-17

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
876 MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	15	$3,401.58	$4,081.90	$3,401.58	nat. median $2,958 1.2× median
876 OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	1	$2,395.35	$2,395.35	$2,395.35	nat. median $1,312 1.8× median
126 CDM	R+b (Detox)	3	$1,779.84	$2,363.85	$2,363.85	—
128 CDM	R+b (sa)	3	$1,779.84	$2,363.85	$2,363.85	—
124 CDM	R+b (mh)	3	$1,779.84	$2,363.85	$2,363.85	nat. median $1,665 1.4× median
56 MS_DRG	Degenerative Nervous System Disorders With Mcc	15	$2,167.62	$2,601.15	$2,167.62	nat. median $14,194 outlier · 0.2×
883 MS_DRG	Disorders Of Personality And Impulse Control	15	$1,604.79	$1,925.75	$1,604.79	nat. median $2,596 0.6× median
886 MS_DRG	Behavioral And Developmental Disorders	15	$1,555.10	$1,866.13	$1,555.10	nat. median $2,736 0.6× median
7594 APR_DRG	Eating Disorders	2	$1,552.76	$1,552.76	$1,552.76	nat. median $28,483 outlier · 0.1×
896 MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	15	$1,541.51	$1,849.82	$1,541.51	nat. median $9,938 outlier · 0.2×
7584 APR_DRG	Disorders Of Impulse Control & Development	2	$1,471.41	$1,471.41	$1,471.41	nat. median $22,778 outlier · 0.1×
884 MS_DRG	Organic Disturbances And Intellectual Disability	15	$1,445.78	$1,734.93	$1,445.78	nat. median $7,732 outlier · 0.2×
917 MS_DRG	Poisoning And Toxic Effects Of Drugs With Mcc	15	$1,419.37	$1,703.25	$1,419.37	nat. median $10,747 outlier · 0.1×
7574 APR_DRG	Organic Mental Health Conditions And Disturbances	2	$1,328.85	$1,328.85	$1,328.85	nat. median $19,457 outlier · 0.1×
895 MS_DRG	Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy	15	$1,253.35	$1,504.01	$1,253.35	nat. median $2,596 outlier · 0.5×
7524 APR_DRG	Personality Disorders	2	$1,241.68	$1,241.68	$1,241.68	nat. median $18,402 outlier · 0.1×
885 MS_DRG	Psychoses	15	$1,220.19	$1,464.23	$1,220.19	nat. median $8,240 outlier · 0.1×
57 MS_DRG	Degenerative Nervous System Disorders Without Mcc	15	$1,155.10	$1,386.12	$1,155.10	nat. median $8,924 outlier · 0.1×
7754 APR_DRG	Alcohol Abuse And Dependence	2	$1,152.23	$1,152.23	$1,152.23	nat. median $19,303 outlier · 0.1×
0128 RC	H4h Ip Rehab	24	$600.00	$2,061.00	$1,121.00	nat. median $16,781 outlier · 0.1×
947 MS_DRG	Signs And Symptoms With Mcc	15	$1,113.37	$1,336.05	$1,113.37	nat. median $8,698 outlier · 0.1×
7504 APR_DRG	Schizophrenia And Other Severe Psychotic Disorders	2	$1,095.56	$1,095.56	$1,095.56	nat. median $17,777 outlier · 0.1×
887 MS_DRG	Other Mental Disorder Diagnoses	15	$1,029.58	$1,235.50	$1,029.58	nat. median $2,736 outlier · 0.4×
7724 APR_DRG	Alcohol And Drug Dependence With Rehabilitation And/or Detoxification Therapy	2	$1,005.96	$1,005.96	$1,005.96	nat. median $14,176 outlier · 0.1×
7604 APR_DRG	Other Mental Health Conditions And Disorders	2	$965.12	$965.12	$965.12	nat. median $11,936 outlier · 0.1×
917 OTHER	Poisoning And Toxic Effects Of Drugs Age >17 With Mcc	1	$943.13	$943.13	$943.13	nat. median $6 outlier · 159.0×
7744 APR_DRG	Cocaine Abuse And Dependence	2	$934.46	$934.46	$934.46	nat. median $15,092 outlier · 0.1×
7593 APR_DRG	Eating Disorders	2	$926.25	$926.25	$926.25	nat. median $13,047 outlier · 0.1×
884 OTHER	Organic Disturbances And Intellectual Disability	1	$922.69	$922.69	$922.69	nat. median $2,413 outlier · 0.4×
947 OTHER	Signs And Symptoms With Mcc	1	$893.02	$893.02	$893.02	nat. median $59 outlier · 15.2×
7734 APR_DRG	Opioid Abuse And Dependence	2	$891.41	$891.41	$891.41	nat. median $14,792 outlier · 0.1×
7514 APR_DRG	Depressive Disorders	2	$886.43	$886.43	$886.43	nat. median $14,895 outlier · 0.1×
887 OTHER	Other Mental Disorder Diagnoses	1	$877.55	$877.55	$877.55	nat. median $247 outlier · 3.5×
0124 RC	H4h Ip Psych	43	$18.44	$2,061.00	$875.00	nat. median $861 1.0× median
0126 RC	H4h Ip Cd	38	$18.44	$2,061.00	$875.00	nat. median $858 1.0× median
886 OTHER	Behavioral And Developmental Disorders	1	$871.44	$871.44	$871.44	nat. median $203,660 outlier · 0.0×
883 OTHER	Disorders Of Personality And Impulse Control	1	$870.16	$870.16	$870.16	nat. median $15 outlier · 59.9×
882 MS_DRG	Neuroses Except Depressive	15	$832.74	$999.28	$832.74	nat. median $2,633 outlier · 0.3×
896 OTHER	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	1	$832.12	$832.12	$832.12	nat. median $19 outlier · 44.6×
880 MS_DRG	Acute Adjustment Reaction And Psychosocial Dysfunction	15	$829.79	$995.75	$829.79	nat. median $4,519 outlier · 0.2×
7534 APR_DRG	Bipolar Disorders	2	$829.34	$829.34	$829.34	nat. median $13,656 outlier · 0.1×
7764 APR_DRG	Other Drug Abuse And Dependence	2	$828.33	$828.33	$828.33	nat. median $12,514 outlier · 0.1×
7564 APR_DRG	Acute Anxiety And Stress Syndromes	2	$798.09	$798.09	$798.09	nat. median $10,975 outlier · 0.1×
881 MS_DRG	Depressive Neuroses	15	$791.27	$949.53	$791.27	nat. median $2,958 outlier · 0.3×
918 MS_DRG	Poisoning And Toxic Effects Of Drugs Without Mcc	15	$765.74	$918.88	$765.74	nat. median $5,899 outlier · 0.1×
897 MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc	15	$763.66	$916.39	$763.66	nat. median $5,898 outlier · 0.1×
7704 APR_DRG	Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice	2	$736.66	$736.66	$736.66	nat. median $10,999 outlier · 0.1×
948 MS_DRG	Signs And Symptoms Without Mcc	15	$687.74	$825.29	$687.74	nat. median $5,562 outlier · 0.1×
7592 APR_DRG	Eating Disorders	2	$655.00	$655.00	$655.00	nat. median $8,407 outlier · 0.1×
899 OTHER	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Age <=21 Withou	1	$622.15	$622.15	$622.15	nat. median $1,480 outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 123 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	15	15	$2,781.00	$950.00 66% off	$3,401.58	$4,081.90	$3,401.58	2025-09-25
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	1	1	$2,781.00	$950.00 66% off	$2,395.35	$2,395.35	$2,395.35	2025-09-25
128	CDM	R+b (sa)	3	3	$2,781.00	$950.00 66% off	$1,779.84	$2,363.85	$2,363.85	2025-09-25
126	CDM	R+b (Detox)	3	3	$2,781.00	$950.00 66% off	$1,779.84	$2,363.85	$2,363.85	2025-09-25
124	CDM	R+b (mh)	3	3	$2,781.00	$950.00 66% off	$1,779.84	$2,363.85	$2,363.85	2025-09-25
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	15	15	$2,781.00	$950.00 66% off	$2,167.62	$2,601.15	$2,167.62	2025-09-25
883	MS_DRG	Disorders Of Personality And Impulse Control	15	15	$2,781.00	$950.00 66% off	$1,604.79	$1,925.75	$1,604.79	2025-09-25
886	MS_DRG	Behavioral And Developmental Disorders	15	15	$2,781.00	$950.00 66% off	$1,555.10	$1,866.13	$1,555.10	2025-09-25
7594	APR_DRG	Eating Disorders	2	2	$2,781.00	$950.00 66% off	$1,552.76	$1,552.76	$1,552.76	2025-09-25
896	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	15	15	$2,781.00	$950.00 66% off	$1,541.51	$1,849.82	$1,541.51	2025-09-25
7584	APR_DRG	Disorders Of Impulse Control & Development	2	2	$2,781.00	$950.00 66% off	$1,471.41	$1,471.41	$1,471.41	2025-09-25
884	MS_DRG	Organic Disturbances And Intellectual Disability	15	15	$2,781.00	$950.00 66% off	$1,445.78	$1,734.93	$1,445.78	2025-09-25
917	MS_DRG	Poisoning And Toxic Effects Of Drugs With Mcc	15	15	$2,781.00	$950.00 66% off	$1,419.37	$1,703.25	$1,419.37	2025-09-25
7574	APR_DRG	Organic Mental Health Conditions And Disturbances	2	2	$2,781.00	$950.00 66% off	$1,328.85	$1,328.85	$1,328.85	2025-09-25
895	MS_DRG	Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy	15	15	$2,781.00	$950.00 66% off	$1,253.35	$1,504.01	$1,253.35	2025-09-25
7524	APR_DRG	Personality Disorders	2	2	$2,781.00	$950.00 66% off	$1,241.68	$1,241.68	$1,241.68	2025-09-25
885	MS_DRG	Psychoses	15	15	$2,781.00	$950.00 66% off	$1,220.19	$1,464.23	$1,220.19	2025-09-25
57	MS_DRG	Degenerative Nervous System Disorders Without Mcc	15	15	$2,781.00	$950.00 66% off	$1,155.10	$1,386.12	$1,155.10	2025-09-25
7754	APR_DRG	Alcohol Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$1,152.23	$1,152.23	$1,152.23	2025-09-25
0128	RC	H4h Ip Rehab	29	24	$3,212.97	—	$600.00	$2,061.00	$1,121.00	2026-08-17
947	MS_DRG	Signs And Symptoms With Mcc	15	15	$2,781.00	$950.00 66% off	$1,113.37	$1,336.05	$1,113.37	2025-09-25
7504	APR_DRG	Schizophrenia And Other Severe Psychotic Disorders	2	2	$2,781.00	$950.00 66% off	$1,095.56	$1,095.56	$1,095.56	2025-09-25
887	MS_DRG	Other Mental Disorder Diagnoses	15	15	$2,781.00	$950.00 66% off	$1,029.58	$1,235.50	$1,029.58	2025-09-25
7724	APR_DRG	Alcohol And Drug Dependence With Rehabilitation And/or Detoxification Therapy	2	2	$2,781.00	$950.00 66% off	$1,005.96	$1,005.96	$1,005.96	2025-09-25
7604	APR_DRG	Other Mental Health Conditions And Disorders	2	2	$2,781.00	$950.00 66% off	$965.12	$965.12	$965.12	2025-09-25
917	OTHER	Poisoning And Toxic Effects Of Drugs Age >17 With Mcc	1	1	$2,781.00	$950.00 66% off	$943.13	$943.13	$943.13	2025-09-25
7744	APR_DRG	Cocaine Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$934.46	$934.46	$934.46	2025-09-25
7593	APR_DRG	Eating Disorders	2	2	$2,781.00	$950.00 66% off	$926.25	$926.25	$926.25	2025-09-25
884	OTHER	Organic Disturbances And Intellectual Disability	1	1	$2,781.00	$950.00 66% off	$922.69	$922.69	$922.69	2025-09-25
947	OTHER	Signs And Symptoms With Mcc	1	1	$2,781.00	$950.00 66% off	$893.02	$893.02	$893.02	2025-09-25
7734	APR_DRG	Opioid Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$891.41	$891.41	$891.41	2025-09-25
7514	APR_DRG	Depressive Disorders	2	2	$2,781.00	$950.00 66% off	$886.43	$886.43	$886.43	2025-09-25
887	OTHER	Other Mental Disorder Diagnoses	1	1	$2,781.00	$950.00 66% off	$877.55	$877.55	$877.55	2025-09-25
0126	RC	H4h Ip Cd	38	38	$3,212.97	—	$18.44	$2,061.00	$875.00	2026-08-17
0124	RC	H4h Ip Psych	43	43	$3,212.97	—	$18.44	$2,061.00	$875.00	2026-08-17
886	OTHER	Behavioral And Developmental Disorders	1	1	$2,781.00	$950.00 66% off	$871.44	$871.44	$871.44	2025-09-25
883	OTHER	Disorders Of Personality And Impulse Control	1	1	$2,781.00	$950.00 66% off	$870.16	$870.16	$870.16	2025-09-25
882	MS_DRG	Neuroses Except Depressive	15	15	$2,781.00	$950.00 66% off	$832.74	$999.28	$832.74	2025-09-25
896	OTHER	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	1	1	$2,781.00	$950.00 66% off	$832.12	$832.12	$832.12	2025-09-25
880	MS_DRG	Acute Adjustment Reaction And Psychosocial Dysfunction	15	15	$2,781.00	$950.00 66% off	$829.79	$995.75	$829.79	2025-09-25
7534	APR_DRG	Bipolar Disorders	2	2	$2,781.00	$950.00 66% off	$829.34	$829.34	$829.34	2025-09-25
7764	APR_DRG	Other Drug Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$828.33	$828.33	$828.33	2025-09-25
7564	APR_DRG	Acute Anxiety And Stress Syndromes	2	2	$2,781.00	$950.00 66% off	$798.09	$798.09	$798.09	2025-09-25
881	MS_DRG	Depressive Neuroses	15	15	$2,781.00	$950.00 66% off	$791.27	$949.53	$791.27	2025-09-25
918	MS_DRG	Poisoning And Toxic Effects Of Drugs Without Mcc	15	15	$2,781.00	$950.00 66% off	$765.74	$918.88	$765.74	2025-09-25
897	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc	15	15	$2,781.00	$950.00 66% off	$763.66	$916.39	$763.66	2025-09-25
7704	APR_DRG	Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice	2	2	$2,781.00	$950.00 66% off	$736.66	$736.66	$736.66	2025-09-25
948	MS_DRG	Signs And Symptoms Without Mcc	15	15	$2,781.00	$950.00 66% off	$687.74	$825.29	$687.74	2025-09-25
7592	APR_DRG	Eating Disorders	2	2	$2,781.00	$950.00 66% off	$655.00	$655.00	$655.00	2025-09-25
899	OTHER	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Age <=21 Withou	1	1	$2,781.00	$950.00 66% off	$622.15	$622.15	$622.15	2025-09-25
898	OTHER	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Age >21 Without	1	1	$2,781.00	$950.00 66% off	$610.16	$610.16	$610.16	2025-09-25
7503	APR_DRG	Schizophrenia And Other Severe Psychotic Disorders	2	2	$2,781.00	$950.00 66% off	$566.93	$566.93	$566.93	2025-09-25
894	MS_DRG	Alcohol, Drug Abuse Or Dependence, Left Ama	15	15	$2,781.00	$950.00 66% off	$540.24	$648.29	$540.24	2025-09-25
7573	APR_DRG	Organic Mental Health Conditions And Disturbances	2	2	$2,781.00	$950.00 66% off	$540.23	$540.23	$540.23	2025-09-25
895	OTHER	Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy	1	1	$2,781.00	$950.00 66% off	$522.43	$522.43	$522.43	2025-09-25
7523	APR_DRG	Personality Disorders	2	2	$2,781.00	$950.00 66% off	$521.59	$521.59	$521.59	2025-09-25
948	OTHER	Signs And Symptoms Without Mcc	1	1	$2,781.00	$950.00 66% off	$511.99	$511.99	$511.99	2025-09-25
7753	APR_DRG	Alcohol Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$510.31	$510.31	$510.31	2025-09-25
7591	APR_DRG	Eating Disorders	2	2	$2,781.00	$950.00 66% off	$490.61	$490.61	$490.61	2025-09-25
7723	APR_DRG	Alcohol And Drug Dependence With Rehabilitation And/or Detoxification Therapy	2	2	$2,781.00	$950.00 66% off	$488.86	$488.86	$488.86	2025-09-25
7554	APR_DRG	Adjustment Disorders	2	2	$2,781.00	$950.00 66% off	$480.50	$480.50	$480.50	2025-09-25
7533	APR_DRG	Bipolar Disorders	2	2	$2,781.00	$950.00 66% off	$478.38	$478.38	$478.38	2025-09-25
7603	APR_DRG	Other Mental Health Conditions And Disorders	2	2	$2,781.00	$950.00 66% off	$471.65	$471.65	$471.65	2025-09-25
880	OTHER	Acute Adjustment Reaction And Psychosocial Dysfunction	1	1	$2,781.00	$950.00 66% off	$466.28	$466.28	$466.28	2025-09-25
7513	APR_DRG	Depressive Disorders	2	2	$2,781.00	$950.00 66% off	$462.97	$462.97	$462.97	2025-09-25
7563	APR_DRG	Acute Anxiety And Stress Syndromes	2	2	$2,781.00	$950.00 66% off	$449.57	$449.57	$449.57	2025-09-25
0915	RC	H4h Php Cd 8986	46	41	$401.62	—	$225.00	$940.00	$447.00	2026-08-17
7583	APR_DRG	Disorders Of Impulse Control & Development	2	2	$2,781.00	$950.00 66% off	$436.59	$436.59	$436.59	2025-09-25
7763	APR_DRG	Other Drug Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$436.33	$436.33	$436.33	2025-09-25
7733	APR_DRG	Opioid Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$416.15	$416.15	$416.15	2025-09-25
918	OTHER	Poisoning And Toxic Effects Of Drugs Age >17 Without Mcc	1	1	$2,781.00	$950.00 66% off	$393.38	$393.38	$393.38	2025-09-25
90853	CPT	Group Psychotherapy	33	28	$321.06	—	$385.78	$555.52	$385.78	2026-08-17
90847	CPT	Family Psytx W/pt 50 Min	33	28	$401.62	—	$385.78	$555.52	$385.78	2026-08-17
7502	APR_DRG	Schizophrenia And Other Severe Psychotic Disorders	2	2	$2,781.00	$950.00 66% off	$378.23	$378.23	$378.23	2025-09-25
7572	APR_DRG	Organic Mental Health Conditions And Disturbances	2	2	$2,781.00	$950.00 66% off	$378.07	$378.07	$378.07	2025-09-25
885	OTHER	Psychoses	1	1	$2,781.00	$950.00 66% off	$377.62	$377.62	$377.62	2025-09-25
7743	APR_DRG	Cocaine Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$375.85	$375.85	$375.85	2025-09-25
7553	APR_DRG	Adjustment Disorders	2	2	$2,781.00	$950.00 66% off	$348.58	$348.58	$348.58	2025-09-25
7703	APR_DRG	Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice	2	2	$2,781.00	$950.00 66% off	$343.97	$343.97	$343.97	2025-09-25
882	OTHER	Neuroses Except Depressive	1	1	$2,781.00	$950.00 66% off	$331.06	$331.06	$331.06	2025-09-25
881	OTHER	Depressive Neuroses	1	1	$2,781.00	$950.00 66% off	$325.66	$325.66	$325.66	2025-09-25
7562	APR_DRG	Acute Anxiety And Stress Syndromes	2	2	$2,781.00	$950.00 66% off	$321.20	$321.20	$321.20	2025-09-25
7722	APR_DRG	Alcohol And Drug Dependence With Rehabilitation And/or Detoxification Therapy	2	2	$2,781.00	$950.00 66% off	$315.79	$315.79	$315.79	2025-09-25
7602	APR_DRG	Other Mental Health Conditions And Disorders	2	2	$2,781.00	$950.00 66% off	$300.33	$300.33	$300.33	2025-09-25
7752	APR_DRG	Alcohol Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$281.37	$281.37	$281.37	2025-09-25
894	OTHER	Alcohol, Drug Abuse Or Dependence, Left Ama	1	1	$2,781.00	$950.00 66% off	$273.85	$273.85	$273.85	2025-09-25
7501	APR_DRG	Schizophrenia And Other Severe Psychotic Disorders	2	2	$2,781.00	$950.00 66% off	$273.48	$273.48	$273.48	2025-09-25
912	CDM	Php Daily Rate	16	14	$1,391.00	$950.00 32% off	$268.22	$1,391.00	$270.90	2025-09-25
7582	APR_DRG	Disorders Of Impulse Control & Development	2	2	$2,781.00	$950.00 66% off	$266.86	$266.86	$266.86	2025-09-25
7532	APR_DRG	Bipolar Disorders	2	2	$2,781.00	$950.00 66% off	$260.45	$260.45	$260.45	2025-09-25
7571	APR_DRG	Organic Mental Health Conditions And Disturbances	2	2	$2,781.00	$950.00 66% off	$251.77	$251.77	$251.77	2025-09-25
7601	APR_DRG	Other Mental Health Conditions And Disorders	2	2	$2,781.00	$950.00 66% off	$250.07	$250.07	$250.07	2025-09-25
0906	RC	H4h Iop Cd 8984	60	55	$321.06	—	$125.00	$746.00	$245.00	2026-08-17
0905	RC	H4h Iop Psych 8985	60	55	$321.06	—	$125.00	$746.00	$245.00	2026-08-17
7721	APR_DRG	Alcohol And Drug Dependence With Rehabilitation And/or Detoxification Therapy	2	2	$2,781.00	$950.00 66% off	$239.96	$239.96	$239.96	2025-09-25
7522	APR_DRG	Personality Disorders	2	2	$2,781.00	$950.00 66% off	$234.13	$234.13	$234.13	2025-09-25
905	CDM	Iop Daily Rate	16	14	$600.00	$270.00 55% off	$230.67	$600.00	$232.97	2025-09-25
7762	APR_DRG	Other Drug Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$230.69	$230.69	$230.69	2025-09-25
916	CDM	Iop Services	16	14	$200.00	$270.00	$128.00	$276.80	$230.67	2025-09-25
7512	APR_DRG	Depressive Disorders	2	2	$2,781.00	$950.00 66% off	$227.99	$227.99	$227.99	2025-09-25
7742	APR_DRG	Cocaine Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$214.75	$214.75	$214.75	2025-09-25
7732	APR_DRG	Opioid Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$214.48	$214.48	$214.48	2025-09-25
7561	APR_DRG	Acute Anxiety And Stress Syndromes	2	2	$2,781.00	$950.00 66% off	$209.45	$209.45	$209.45	2025-09-25
7581	APR_DRG	Disorders Of Impulse Control & Development	2	2	$2,781.00	$950.00 66% off	$208.61	$208.61	$208.61	2025-09-25
7702	APR_DRG	Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice	2	2	$2,781.00	$950.00 66% off	$199.44	$199.44	$199.44	2025-09-25
7531	APR_DRG	Bipolar Disorders	2	2	$2,781.00	$950.00 66% off	$195.63	$195.63	$195.63	2025-09-25
7751	APR_DRG	Alcohol Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$185.09	$185.09	$185.09	2025-09-25
7521	APR_DRG	Personality Disorders	2	2	$2,781.00	$950.00 66% off	$177.78	$177.78	$177.78	2025-09-25
7552	APR_DRG	Adjustment Disorders	2	2	$2,781.00	$950.00 66% off	$175.61	$175.61	$175.61	2025-09-25
7511	APR_DRG	Depressive Disorders	2	2	$2,781.00	$950.00 66% off	$169.73	$169.73	$169.73	2025-09-25
7761	APR_DRG	Other Drug Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$167.62	$167.62	$167.62	2025-09-25
7741	APR_DRG	Cocaine Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$160.68	$160.68	$160.68	2025-09-25
7731	APR_DRG	Opioid Abuse And Dependence	2	2	$2,781.00	$950.00 66% off	$144.58	$144.58	$144.58	2025-09-25
7701	APR_DRG	Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice	2	2	$2,781.00	$950.00 66% off	$127.21	$127.21	$127.21	2025-09-25
7551	APR_DRG	Adjustment Disorders	2	2	$2,781.00	$950.00 66% off	$126.04	$126.04	$126.04	2025-09-25
4001F	CPT	Tobacco Use Txmnt Pharmacol	0	0	$33,687.49	—	—	—	—	2026-08-17
0916	RC	Php Psy Family Therapy	0	0	$401.62	—	—	—	—	2026-08-17
S9480	HCPCS	H4h Iop Psych 8985	0	0	$321.06	—	—	—	—	2026-08-17
S0201	HCPCS	H4h Php Cd 8986	0	0	$401.62	—	—	—	—	2026-08-17
H0015	HCPCS	Alcohol And/or Drug Services	0	0	$321.06	—	—	—	—	2026-08-17
H0009	HCPCS	Alcohol And/or Drug Services	0	0	$3,212.97	—	—	—	—	2026-08-17
G0410	HCPCS	Grp Psych Partial Hosp 45-50	0	0	$401.62	—	—	—	—	2026-08-17
4004F	CPT	Pt Tobacco Screen Rcvd Tlk	0	0	$33,687.49	—	—	—	—	2026-08-17

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