hospital_Chicago BH Hospital last_updated_ 2023-12-31 version_1 "hospital_Chicago, Illnois" hospital_address 4720 Clarendon Ave. license_0006296 | IL "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded in this machine-readable file is true, accurate, and complete as of the date indicated in this file" description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AETNA|HMO/PPO] standard_charge|[payer_AETNA|HMO/PPO] |percent standard_charge|[payer_AETNA|HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA|HMO/PPO] standard_charge|[payer_AETNA BETTER HEALTH|MANAGED MEDICAID] standard_charge|[payer_AETNA BETTER HEALTH|MANAGED MEDICAID] |percent standard_charge|[payer_AETNA BETTER HEALTH|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AETNA BETTER HEALTH|MANAGED MEDICAID] standard_charge|[payer_AETNA MEDICARE|MANAGED MEDICARE] standard_charge|[payer_AETNA MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_AETNA MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA MEDICARE|MANAGED MEDICARE] standard_charge|[payer_ALL SAVERS|HMO/PPO] standard_charge|[payer_ALL SAVERS|HMO/PPO] |percent standard_charge|[payer_ALL SAVERS|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALL SAVERS|HMO/PPO] standard_charge|[payer_BCBS HMO|BLUE CROSS] standard_charge|[payer_BCBS HMO|BLUE CROSS] |percent standard_charge|[payer_BCBS HMO|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS HMO|BLUE CROSS] standard_charge|[payer_BCBS IL|BLUE CROSS] standard_charge|[payer_BCBS IL|BLUE CROSS] |percent standard_charge|[payer_BCBS IL|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS IL|BLUE CROSS] standard_charge|[payer_BCBS OUT OF AREA|BLUE CROSS] standard_charge|[payer_BCBS OUT OF AREA|BLUE CROSS] |percent standard_charge|[payer_BCBS OUT OF AREA|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OUT OF AREA|BLUE CROSS] standard_charge|[payer_BEACON HEALTH|HMO/PPO] standard_charge|[payer_BEACON HEALTH|HMO/PPO] |percent standard_charge|[payer_BEACON HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_BEACON HEALTH|HMO/PPO] standard_charge|[payer_BLUE CHOICE|BLUE CROSS] standard_charge|[payer_BLUE CHOICE|BLUE CROSS] |percent standard_charge|[payer_BLUE CHOICE|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BLUE CHOICE|BLUE CROSS] standard_charge|[payer_BLUE CROSS COMMUNITY|MANAGED MEDICAID] standard_charge|[payer_BLUE CROSS COMMUNITY|MANAGED MEDICAID] |percent standard_charge|[payer_BLUE CROSS COMMUNITY|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BLUE CROSS COMMUNITY|MANAGED MEDICAID] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |percent standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] |percent standard_charge|[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_COMPSYCH|HMO/PPO] standard_charge|[payer_COMPSYCH|HMO/PPO] |percent standard_charge|[payer_COMPSYCH|HMO/PPO] |contracting_method additional_payer_notes |[payer_COMPSYCH|HMO/PPO] standard_charge|[payer_COUNTYCARE|MANAGED MEDICAID] standard_charge|[payer_COUNTYCARE|MANAGED MEDICAID] |percent standard_charge|[payer_COUNTYCARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_COUNTYCARE|MANAGED MEDICAID] standard_charge|[payer_DCFS|LOCAL GOVT] standard_charge|[payer_DCFS|LOCAL GOVT] |percent standard_charge|[payer_DCFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_DCFS|LOCAL GOVT] standard_charge|[payer_GOLDEN RULE|HMO/PPO] standard_charge|[payer_GOLDEN RULE|HMO/PPO] |percent standard_charge|[payer_GOLDEN RULE|HMO/PPO] |contracting_method additional_payer_notes |[payer_GOLDEN RULE|HMO/PPO] standard_charge|[payer_HEALTH ALLIANCE|HMO/PPO] standard_charge|[payer_HEALTH ALLIANCE|HMO/PPO] |percent standard_charge|[payer_HEALTH ALLIANCE|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTH ALLIANCE|HMO/PPO] standard_charge|[payer_HEALTH LINK|HMO/PPO] standard_charge|[payer_HEALTH LINK|HMO/PPO] |percent standard_charge|[payer_HEALTH LINK|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTH LINK|HMO/PPO] standard_charge|[payer_HUMANA|HMO/PPO] standard_charge|[payer_HUMANA|HMO/PPO] |percent standard_charge|[payer_HUMANA|HMO/PPO] |contracting_method additional_payer_notes |[payer_HUMANA|HMO/PPO] standard_charge|[payer_ILLINOIS MEDICAID|MEDICAID ] standard_charge|[payer_ILLINOIS MEDICAID|MEDICAID ] |percent standard_charge|[payer_ILLINOIS MEDICAID|MEDICAID ] |contracting_method additional_payer_notes |[payer_ILLINOIS MEDICAID|MEDICAID ] standard_charge|[payer_ILLINOIS MEDICAID|PENDING MEDICAID] standard_charge|[payer_ILLINOIS MEDICAID|PENDING MEDICAID] |percent standard_charge|[payer_ILLINOIS MEDICAID|PENDING MEDICAID] |contracting_method additional_payer_notes |[payer_ILLINOIS MEDICAID|PENDING MEDICAID] standard_charge|[payer_MAGELLAN HEALTH SERVICES|HMO/PPO] standard_charge|[payer_MAGELLAN HEALTH SERVICES|HMO/PPO] |percent standard_charge|[payer_MAGELLAN HEALTH SERVICES|HMO/PPO] |contracting_method additional_payer_notes |[payer_MAGELLAN HEALTH SERVICES|HMO/PPO] standard_charge|[payer_MEDICA|HMO/PPO] standard_charge|[payer_MEDICA|HMO/PPO] |percent standard_charge|[payer_MEDICA|HMO/PPO] |contracting_method additional_payer_notes |[payer_MEDICA|HMO/PPO] standard_charge|[payer_MERIDIAN MEDICAID|MANAGED MEDICAID] standard_charge|[payer_MERIDIAN MEDICAID|MANAGED MEDICAID] |percent standard_charge|[payer_MERIDIAN MEDICAID|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MERIDIAN MEDICAID|MANAGED MEDICAID] standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] |percent standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_MERITAIN HEALTH|HMO/PPO] standard_charge|[payer_MHN|HMO/PPO] standard_charge|[payer_MHN|HMO/PPO] |percent standard_charge|[payer_MHN|HMO/PPO] |contracting_method additional_payer_notes |[payer_MHN|HMO/PPO] standard_charge|[payer_MISC COMMERCIAL|COMMERCIAL] standard_charge|[payer_MISC COMMERCIAL|COMMERCIAL] |percent standard_charge|[payer_MISC COMMERCIAL|COMMERCIAL] |contracting_method additional_payer_notes |[payer_MISC COMMERCIAL|COMMERCIAL] standard_charge|[payer_MISC HMO/PPO|HMO/PPO] standard_charge|[payer_MISC HMO/PPO|HMO/PPO] |percent standard_charge|[payer_MISC HMO/PPO|HMO/PPO] |contracting_method additional_payer_notes |[payer_MISC HMO/PPO|HMO/PPO] standard_charge|[payer_MISC OUT OF STATE MCAID|MANAGED MEDICAID] standard_charge|[payer_MISC OUT OF STATE MCAID|MANAGED MEDICAID] |percent standard_charge|[payer_MISC OUT OF STATE MCAID|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MISC OUT OF STATE MCAID|MANAGED MEDICAID] standard_charge|[payer_MN UCARE|MEDICAID: OUT OF STATE] standard_charge|[payer_MN UCARE|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MN UCARE|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MN UCARE|MEDICAID: OUT OF STATE] standard_charge|[payer_MOLINA MEDICAID|MANAGED MEDICAID] standard_charge|[payer_MOLINA MEDICAID|MANAGED MEDICAID] |percent standard_charge|[payer_MOLINA MEDICAID|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MOLINA MEDICAID|MANAGED MEDICAID] standard_charge|[payer_SUREST|HMO/PPO] standard_charge|[payer_SUREST|HMO/PPO] |percent standard_charge|[payer_SUREST|HMO/PPO] |contracting_method additional_payer_notes |[payer_SUREST|HMO/PPO] standard_charge|[payer_TRICARE EAST|TRICARE] standard_charge|[payer_TRICARE EAST|TRICARE] |percent standard_charge|[payer_TRICARE EAST|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE EAST|TRICARE] standard_charge|[payer_TRICARE WEST|TRICARE] standard_charge|[payer_TRICARE WEST|TRICARE] |percent standard_charge|[payer_TRICARE WEST|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE WEST|TRICARE] standard_charge|[payer_UBH OPTUM|HMO/PPO] standard_charge|[payer_UBH OPTUM|HMO/PPO] |percent standard_charge|[payer_UBH OPTUM|HMO/PPO] |contracting_method additional_payer_notes |[payer_UBH OPTUM|HMO/PPO] standard_charge|[payer_YOUTHCARE|MANAGED MEDICAID] standard_charge|[payer_YOUTHCARE|MANAGED MEDICAID] |percent standard_charge|[payer_YOUTHCARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_YOUTHCARE|MANAGED MEDICAID] ROOM AND BOARD ADOLESCENT BOYS 124 RC facility inpatient 3000 850 900 3000 900 per diem 1468.74 per diem 986 per diem 1000 per diem 1100 per diem 1100 per diem 925 per diem 1012 per diem 1468.74 per diem 3000 per diem 1005 per diem 1400 per diem 1468.74 per diem 3000 per diem 986 per diem 3000 per diem 3000 per diem 1050 per diem 1468.74 per diem 1468.74 per diem 965 per diem 3000 per diem 1468.74 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 1468.74 per diem 986 per diem 3000 per diem 3000 per diem 986 per diem 1468.74 per diem ROOM AND BOARD ADOLESCENT GIRLS 124 RC facility inpatient 3000 850 900 3000 900 per diem 1468.74 per diem 986 per diem 1000 per diem 1100 per diem 1100 per diem 925 per diem 1012 per diem 1468.74 per diem 3000 per diem 1005 per diem 1400 per diem 1468.74 per diem 3000 per diem 986 per diem 3000 per diem 3000 per diem 1050 per diem 1468.74 per diem 1468.74 per diem 965 per diem 3000 per diem 1468.74 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 1468.74 per diem 986 per diem 3000 per diem 3000 per diem 986 per diem 1468.74 per diem ROOM AND BOARD CHILDREN 124 RC facility inpatient 3000 850 900 3000 900 per diem 1468.74 per diem 986 per diem 1000 per diem 1100 per diem 1100 per diem 925 per diem 1012 per diem 1468.74 per diem 3000 per diem 1005 per diem 1400 per diem 1468.74 per diem 3000 per diem 986 per diem 3000 per diem 3000 per diem 1050 per diem 1468.74 per diem 1468.74 per diem 965 per diem 3000 per diem 1468.74 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 1468.74 per diem 986 per diem 3000 per diem 3000 per diem 986 per diem 1468.74 per diem OTHER ROOM AND BOARD ADMIN BOY 169 RC facility inpatient 3000 0 289.48 3000 289.48 per diem 289.48 per diem 289.48 per diem 3000 per diem 1468.74 per diem 289.48 per diem 289.48 per diem 400 per diem OTHER ROOM AND BOARD ADMIN CHIL 169 RC facility inpatient 3000 0 289.48 3000 289.48 per diem 289.48 per diem 289.48 per diem 3000 per diem 1468.74 per diem 289.48 per diem 289.48 per diem 400 per diem OTHER ROOM AND BOARD ADMIN GIRL 169 RC facility inpatient 3000 0 289.48 3000 289.48 per diem 289.48 per diem 289.48 per diem 3000 per diem 1468.74 per diem 289.48 per diem 289.48 per diem 400 per diem INTENSIVE OUTPATIENT PROGRAM PSYCH 905 RC facility outpatient 600 300 161.08 300 215 per diem 161.08 per diem 215 per diem 284 per diem 270 per diem 300 per diem 300 per diem 225 per diem 280 per diem 161.08 per diem 300 per diem 161.08 per diem 300 per diem 161.08 per diem 240 per diem 161.08 per diem 161.08 per diem 284 per diem 284 per diem 161.08 per diem PARTIAL HOSPITAL PROGRAM PSYCH 912 RC facility outpatient 900 400 161.08 600 375 per diem 161.08 per diem 375 per diem 371 per diem 410 per diem 450 per diem 450 per diem 425 per diem 425 per diem 161.08 per diem 600 per diem 161.08 per diem 560 per diem 161.08 per diem 405 per diem 161.08 per diem 161.08 per diem 371 per diem 371 per diem 161.08 per diem INTENSIVE OUTPATIENT PROGRAM GRP THERAPY 1 915 RC facility outpatient 200 0 161.08 600 375 per diem 161.08 per diem 375 per diem 371 per diem 410 per diem 450 per diem 450 per diem 425 per diem 425 per diem 161.08 per diem 600 per diem 161.08 per diem 560 per diem 161.08 per diem 405 per diem 161.08 per diem 161.08 per diem 371 per diem 371 per diem 161.08 per diem PARTIAL HOSPITAL PROGRAM PSYCHOTHRPY GRP1 915 RC facility outpatient 300 0 161.08 600 375 per diem 161.08 per diem 375 per diem 371 per diem 410 per diem 450 per diem 450 per diem 425 per diem 425 per diem 161.08 per diem 600 per diem 161.08 per diem 560 per diem 161.08 per diem 405 per diem 161.08 per diem 161.08 per diem 371 per diem 371 per diem 161.08 per diem