{ "hospital_name": "SBH-Davenport, LLC", "last_updated_on": "2026-05-13", "version": "3.0.0", "location_name": [ "Eagle View Behavioral Health" ], "hospital_address": [ "770 Tanglefoot Lane, Bettendorf, IA 52722" ], "license_information": { "state": "IA", "license_number": "139" }, "type_2_npi": [ "1831720556" ], "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": "Adam Curl" }, "standard_charge_information": [ { "description": "Acute Psych Adol R&B", "code_information": [ { "code": "124", "type": "RC" }, { "code": "902", "type": "LOCAL" } ], "standard_charges": [ { "setting": "inpatient", "payers_information": [ { "payer_name": "7th Judicial District", "plan_name": "7th Judicial District", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Administrative Concepts-Continental Care", "plan_name": "Administrative Concepts-Continental Care", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Aetna", "plan_name": "Aetna", "standard_charge_dollar": 1016.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Aetna Better Health Of IL Medicaid", "plan_name": "Aetna Better Health Of IL Medicaid", "standard_charge_dollar": 963.69, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "All Savers", "plan_name": "All Savers", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Allegiance Benefit Plan Management, Inc.", "plan_name": "Allegiance Benefit Plan Management, Inc.", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Allied Benefit Systems", "plan_name": "Allied Benefit Systems", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Ambetter Home State Health", "plan_name": "Ambetter Home State Health", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Ambetter Of Illinois", "plan_name": "Ambetter Of Illinois", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Assured Benefit Administrators", "plan_name": "Assured Benefit Administrators", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Auxiant", "plan_name": "Auxiant", "standard_charge_dollar": 922.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Avera Health Plans", "plan_name": "Avera Health Plans", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "AZ Medicaid - Complete Health", "plan_name": "AZ Medicaid - Complete Health", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Benefit Administrative Systems BAS", "plan_name": "Benefit Administrative Systems BAS", "standard_charge_dollar": 871.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Bind Benefits", "plan_name": "Bind Benefits", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Cigna Behavioral Health", "plan_name": "Cigna Behavioral Health", "standard_charge_dollar": 918.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Consociate Health", "plan_name": "Consociate Health", "standard_charge_dollar": 871.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Dean Health Plan Commerical", "plan_name": "Dean Health Plan Commerical", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Denver Health Medicaid Choice - Colorado", "plan_name": "Denver Health Medicaid Choice - Colorado", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "East Central Region", "plan_name": "East Central Region", "standard_charge_dollar": 750.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Eastern Iowa MHDS - Scott County", "plan_name": "Eastern Iowa MHDS - Scott County", "standard_charge_dollar": 750.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Employee Benefit Management Services (EB", "plan_name": "Employee Benefit Management Services (EB", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Employee Benefit Systems", "plan_name": "Employee Benefit Systems", "standard_charge_dollar": 871.0, "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": "FL Medicaid - Humana Healthy Horizons", "plan_name": "FL Medicaid - Humana Healthy Horizons", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "FL Medicaid - Sunshine State Health Pl", "plan_name": "FL Medicaid - Sunshine State Health Pl", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "GEHA - UHC", "plan_name": "GEHA - UHC", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Global Excel Management", "plan_name": "Global Excel Management", "standard_charge_dollar": 1414.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Golden Rule Insurance", "plan_name": "Golden Rule Insurance", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "GPA", "plan_name": "GPA", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Gravie Administrators", "plan_name": "Gravie Administrators", "standard_charge_dollar": 973.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Group Health Coop - Commerical", "plan_name": "Group Health Coop - Commerical", "standard_charge_dollar": 1050.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Health Alliance", "plan_name": "Health Alliance", "standard_charge_dollar": 871.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Health Partners", "plan_name": "Health Partners", "standard_charge_dollar": 950.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "HealthComp", "plan_name": "HealthComp", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Healthscope", "plan_name": "Healthscope", "standard_charge_dollar": 871.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "HFN", "plan_name": "HFN", "standard_charge_dollar": 945.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Humana", "plan_name": "Humana", "standard_charge_dollar": 900.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "IA Medicaid - Molina", "plan_name": "IA Medicaid - Molina", "standard_charge_dollar": 850.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "IA Medicaid - Total Care", "plan_name": "IA Medicaid - Total Care", "standard_charge_dollar": 750.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "IA Medicaid - Wellpoint - Amerigroup", "plan_name": "IA Medicaid - Wellpoint - Amerigroup", "standard_charge_dollar": 834.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "IL BCBS Medicaid Community Plan", "plan_name": "IL BCBS Medicaid Community Plan", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "IL Medicaid - All Kids", "plan_name": "IL Medicaid - All Kids", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Illinois Medicaid - IL Meridian", "plan_name": "Illinois Medicaid - IL Meridian", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Illinois Medicaid - Illinicare/Youthcare", "plan_name": "Illinois Medicaid - Illinicare/Youthcare", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Illinois Medicaid - Molina", "plan_name": "Illinois Medicaid - Molina", "standard_charge_dollar": 700.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Illinois Medicaid - Wellcare", "plan_name": "Illinois Medicaid - Wellcare", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Imagine360", "plan_name": "Imagine360", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Impact Health Sharing", "plan_name": "Impact Health Sharing", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Indiana Medicaid - MD Wise", "plan_name": "Indiana Medicaid - MD Wise", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Indiana Medicaid-Hoosier Healthwise", "plan_name": "Indiana Medicaid-Hoosier Healthwise", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Inland Empire Health Plan - CA Medicaid", "plan_name": "Inland Empire Health Plan - CA Medicaid", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "International Benefit Administrators", "plan_name": "International Benefit Administrators", "standard_charge_dollar": 700.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "International Student Protection", "plan_name": "International Student Protection", "standard_charge_dollar": 700.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Kaiser-Cigna", "plan_name": "Kaiser-Cigna", "standard_charge_dollar": 900.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Loomis Co", "plan_name": "Loomis Co", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Magellan", "plan_name": "Magellan", "standard_charge_dollar": 900.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Magnacare", "plan_name": "Magnacare", "standard_charge_dollar": 850.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Medi-Share", "plan_name": "Medi-Share", "standard_charge_dollar": 750.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Medica", "plan_name": "Medica", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Medical Associates", "plan_name": "Medical Associates", "standard_charge_dollar": 750.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Meridan Health Medicare Advantage - IL", "plan_name": "Meridan Health Medicare Advantage - IL", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Meritain Health", "plan_name": "Meritain Health", "standard_charge_dollar": 945.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Michigan Medicaid - Meridian Health", "plan_name": "Michigan Medicaid - Meridian Health", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Midland Choice", "plan_name": "Midland Choice", "standard_charge_dollar": 991.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Midlands Choice", "plan_name": "Midlands Choice", "standard_charge_dollar": 991.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Mines And Associates", "plan_name": "Mines And Associates", "standard_charge_dollar": 1100.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "MN Medicaid - Health Partners", "plan_name": "MN Medicaid - Health Partners", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "National Association Of Letter Carriers", "plan_name": "National Association Of Letter Carriers", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Nebraska Total Care", "plan_name": "Nebraska Total Care", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "NY Medicaid - Fidelis Care", "plan_name": "NY Medicaid - Fidelis Care", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Ohio Medicaid - Aetna Better Health", "plan_name": "Ohio Medicaid - Aetna Better Health", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "OK Medicaid - HP Administrative Services", "plan_name": "OK Medicaid - HP Administrative Services", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Optum Health - United Healthcare", "plan_name": "Optum Health - United Healthcare", "standard_charge_dollar": 1129.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Oscar Health", "plan_name": "Oscar Health", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Plumbers & Pipefitters LU # 25", "plan_name": "Plumbers & Pipefitters LU # 25", "standard_charge_dollar": 750.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Prairie States Enterprises, Inc.", "plan_name": "Prairie States Enterprises, Inc.", "standard_charge_dollar": 850.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Preferred One", "plan_name": "Preferred One", "standard_charge_dollar": 700.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Prevea 360", "plan_name": "Prevea 360", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Quad City Community Healthcare", "plan_name": "Quad City Community Healthcare", "standard_charge_dollar": 1050.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Quartz One Health", "plan_name": "Quartz One Health", "standard_charge_dollar": 1250.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Regional Care Inc", "plan_name": "Regional Care Inc", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Sandhills Center", "plan_name": "Sandhills Center", "standard_charge_dollar": 593.61, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Sano-Nomi Health", "plan_name": "Sano-Nomi Health", "standard_charge_dollar": 1372.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "SHP - Sanford Health Plan", "plan_name": "SHP - Sanford Health Plan", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Sisco Benefits", "plan_name": "Sisco Benefits", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Surest", "plan_name": "Surest", "standard_charge_dollar": 750.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "The Alliance", "plan_name": "The Alliance", "standard_charge_dollar": 1200.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "The Benefit Group", "plan_name": "The Benefit Group", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "TN MCO UHC Medicaid", "plan_name": "TN MCO UHC Medicaid", "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": 783.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Tricare For Life", "plan_name": "Tricare For Life", "standard_charge_dollar": 711.4, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Tricare West Region Claims", "plan_name": "Tricare West Region Claims", "standard_charge_dollar": 877.8, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Trust Health Mark Benefits", "plan_name": "Trust Health Mark Benefits", "standard_charge_dollar": 850.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "UHC Alaska Medicaid", "plan_name": "UHC Alaska Medicaid", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "UMR", "plan_name": "UMR", "standard_charge_dollar": 1129.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "United Healthcare Medicaid Community Pla", "plan_name": "United Healthcare Medicaid Community Pla", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "United Healthcare Shared Services", "plan_name": "United Healthcare Shared Services", "standard_charge_dollar": 1129.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "United Healthcare Student Resources", "plan_name": "United Healthcare Student Resources", "standard_charge_dollar": 1129.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "UPMC Health Plan", "plan_name": "UPMC Health Plan", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "US Health Group", "plan_name": "US Health Group", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "WI Medicaid - Group Health Coop South Ce", "plan_name": "WI Medicaid - Group Health Coop South Ce", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "WI Medicaid-Anthem", "plan_name": "WI Medicaid-Anthem", "standard_charge_dollar": 661.79, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Wisconsin Medicaid - UHC", "plan_name": "Wisconsin Medicaid - UHC", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "WPS Health Insurance", "plan_name": "WPS Health Insurance", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" } ], "gross_charge": 3000.0, "discounted_cash": 750.0, "minimum": 500.0, "maximum": 1414.0 } ] }, { "description": "Acute Psych Adult R&B", "code_information": [ { "code": "124", "type": "RC" }, { "code": "901", "type": "LOCAL" } ], "standard_charges": [ { "setting": "inpatient", "payers_information": [ { "payer_name": "7th Judicial District", "plan_name": "7th Judicial District", "standard_charge_dollar": 500.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Administrative Concepts-Continental Care", "plan_name": "Administrative Concepts-Continental Care", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Aetna", "plan_name": "Aetna", "standard_charge_dollar": 1016.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Aetna Better Health Of IL Medicaid", "plan_name": "Aetna Better Health Of IL Medicaid", "standard_charge_dollar": 963.69, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "All Savers", "plan_name": "All Savers", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Allegiance Benefit Plan Management, Inc.", "plan_name": "Allegiance Benefit Plan Management, Inc.", "standard_charge_dollar": 1000.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Allied Benefit Systems", "plan_name": "Allied Benefit Systems", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Ambetter Home State Health", "plan_name": "Ambetter Home State Health", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Ambetter Of Illinois", "plan_name": "Ambetter Of Illinois", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Assured Benefit Administrators", "plan_name": "Assured Benefit Administrators", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Auxiant", "plan_name": "Auxiant", "standard_charge_dollar": 922.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "Avera Health Plans", "plan_name": "Avera Health Plans", "standard_charge_dollar": 800.0, "methodology": "fee schedule", "additional_payer_notes": "" }, { "payer_name": "AZ Medicaid - 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