hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|IA,"To the best of its knowledge and belief, the 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 indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
SBH Davenport LLC dba Eagle View Behavioral Health,11/25/2025,2.0.0,SBH_Davenport_LLC_dba_Eagle_View_Behavioral_Health,"770 Tanglefoot Lane, Bettendorf, IA  52722",820043H,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,modifiers,standard_charge|Aetna Health Inc|Medicare|negotiated_dollar,standard_charge|Aetna Health Inc|Medicare|negotiated_percentage,standard_charge|Aetna Health Inc|Medicare|negotiated_algorithm,estimated_amount|Aetna Health Inc|Medicare,standard_charge|Aetna Health Inc|Medicare|methodology,additional_payer_notes|Aetna Health Inc|Medicare,standard_charge|Aetna Better Health IL MCO|Aetna Better_Health_of_IL_Inc|negotiated_dollar,standard_charge|Aetna Better Health IL MCO|Aetna Better_Health_of_IL_Inc|negotiated_percentage,standard_charge|Aetna Better Health IL MCO|Aetna Better_Health_of_IL_Inc|negotiated_algorithm,estimated_amount|Aetna Better Health IL MCO|Aetna Better_Health_of_IL_Inc,standard_charge|Aetna Better Health IL MCO|Aetna Better_Health_of_IL_Inc|methodology,additional_payer_notes|Aetna Better Health IL MCO|Aetna Better_Health_of_IL_Inc,standard_charge|Amerigroup Iowa|Amerigroup HMO and PPO|negotiated_dollar,standard_charge|Amerigroup Iowa|Amerigroup HMO and PPO|negotiated_percentage,standard_charge|Amerigroup Iowa|Amerigroup HMO and PPO|negotiated_algorithm,estimated_amount|Amerigroup Iowa|Amerigroup HMO and PPO,standard_charge|Amerigroup Iowa|Amerigroup HMO and PPO|methodology,additional_payer_notes|Amerigroup Iowa|Amerigroup HMO and PPO,standard_charge|Wellmark BCBS of IA|Wellmark BCBS of IA|negotiated_dollar,standard_charge|Wellmark BCBS of IA|Wellmark BCBS of IA|negotiated_percentage,standard_charge|Wellmark BCBS of IA|Wellmark BCBS of IA|negotiated_algorithm,estimated_amount|Wellmark BCBS of IA|Wellmark BCBS of IA,standard_charge|Wellmark BCBS of IA|Wellmark BCBS of IA|methodology,additional_payer_notes|Wellmark BCBS of IA|Wellmark BCBS of IA,standard_charge|Evernorth Behavioral Health Inc|Medicare|negotiated_dollar,standard_charge|Evernorth Behavioral Health Inc|Medicare|negotiated_percentage,standard_charge|Evernorth Behavioral Health Inc|Medicare|negotiated_algorithm,estimated_amount|Evernorth Behavioral Health Inc|Medicare,standard_charge|Evernorth Behavioral Health Inc|Medicare|methodology,additional_payer_notes|Evernorth Behavioral Health Inc|Medicare,standard_charge|Wellmark Inc|Wellmark|negotiated_dollar,standard_charge|Wellmark Inc|Wellmark|negotiated_percentage,standard_charge|Wellmark Inc|Wellmark|negotiated_algorithm,estimated_amount|Wellmark Inc|Wellmark,standard_charge|Wellmark Inc|Wellmark|methodology,additional_payer_notes|Wellmark Inc|Wellmark,standard_charge|Health Alliance Medical Plans Inc|Health Alliance|negotiated_dollar,standard_charge|Health Alliance Medical Plans Inc|Health Alliance|negotiated_percentage,standard_charge|Health Alliance Medical Plans Inc|Health Alliance|negotiated_algorithm,estimated_amount|Health Alliance Medical Plans Inc| Health Alliance,standard_charge|Health Alliance Medical Plans Inc|Health Alliance|methodology,additional_payer_notes|Health Alliance Medical Plans Inc|Health Alliance,standard_charge|Humana|Humana Behavioral Health Inc|negotiated_dollar,standard_charge|Humana|Humana Behavioral Health Inc|negotiated_percentage,standard_charge|Humana|Humana Behavioral Health Inc|negotiated_algorithm,estimated_amount|Humana|Humana Behavioral Health Inc,standard_charge|Humana|Humana Behavioral Health Inc|methodology,additional_payer_notes|Humana|Humana Behavioral Health Inc,standard_charge|Health Value Management|Humana Behavioral Health Network|negotiated_dollar,standard_charge|Health Value Management|Humana Behavioral Health Network|negotiated_percentage,standard_charge|Health Value Management|Humana Behavioral Health Network|negotiated_algorithm,estimated_amount|Health Value Management|Humana Behavioral Health Network,standard_charge|Health Value Management|Humana Behavioral Health Network|methodology,additional_payer_notes|Health Value Management|Humana Behavioral Health Network,standard_charge|Molina Healthcare of Illinois Inc|Medicaid|negotiated_dollar,standard_charge|Molina Healthcare of Illinois Inc|Medicaid|negotiated_percentage,standard_charge|Molina Healthcare of Illinois Inc|Medicaid|negotiated_algorithm,estimated_amount|Molina Healthcare of Illinois Inc|Medicaid,standard_charge|Molina Healthcare of Illinois Inc|Medicaid|methodology,additional_payer_notes|Molina Healthcare of Illinois Inc|Medicaid,standard_charge|IA Total Care|Iowa Total Care Inc|negotiated_dollar,standard_charge|IA Total Care|Iowa Total Care Inc|negotiated_percentage,standard_charge|IA Total Care|Iowa Total Care Inc|negotiated_algorithm,estimated_amount|IA Total Care|Iowa Total Care Inc,standard_charge|IA Total Care|Iowa Total Care Inc|methodology,additional_payer_notes|IA Total Care|Iowa Total Care Inc,standard_charge|Carelon|Carelon Behavioral Health Strategies Inc|negotiated_dollar,standard_charge|Carelon|Carelon Behavioral Health Strategies Inc|negotiated_percentage,standard_charge|Carelon|Carelon Behavioral Health Strategies Inc|negotiated_algorithm,estimated_amount|Carelon|Carelon Behavioral Health Strategies Inc,standard_charge|Carelon|Carelon Behavioral Health Strategies Inc|methodology,additional_payer_notes|Carelon|Carelon Behavioral Health Strategies Inc,standard_charge|Evernorth Behavioral Health Inc|Commercial|negotiated_dollar,standard_charge|Evernorth Behavioral Health Inc|Commercial|negotiated_percentage,standard_charge|Evernorth Behavioral Health Inc|Commercial|negotiated_algorithm,estimated_amount|Evernorth Behavioral Health Inc|Commercial,standard_charge|Evernorth Behavioral Health Inc|Commercial|methodology,additional_payer_notes|Evernorth Behavioral Health Inc|Commercial,standard_charge|Molina Healthcare of Illinois Inc|Medicare|negotiated_dollar,standard_charge|Molina Healthcare of Illinois Inc|Medicare|negotiated_percentage,standard_charge|Molina Healthcare of Illinois Inc|Medicare|negotiated_algorithm,estimated_amount|Molina Healthcare of Illinois Inc|Medicare,standard_charge|Molina Healthcare of Illinois Inc|Medicare|methodology,additional_payer_notes|Molina Healthcare of Illinois Inc|Medicare,standard_charge|Optum|United Behavioral Health|negotiated_dollar,standard_charge|Optum|United Behavioral Health|negotiated_percentage,standard_charge|Optum|United Behavioral Health|negotiated_algorithm,estimated_amount|Optum|United Behavioral Health,standard_charge|Optum|United Behavioral Health|methodology,additional_payer_notes|Optum|United Behavioral Health,standard_charge|Quartz Health Solutions Inc|Medicare|negotiated_dollar,standard_charge|Quartz Health Solutions Inc|Medicare|negotiated_percentage,standard_charge|Quartz Health Solutions Inc|Medicare|negotiated_algorithm,estimated_amount|Quartz Health Solutions Inc|Medicare,standard_charge|Quartz Health Solutions Inc|Medicare|methodology,additional_payer_notes|Quartz Health Solutions Inc|Medicare,standard_charge|Aetna Health Inc|Commercial|negotiated_dollar,standard_charge|Aetna Health Inc|Commercial|negotiated_percentage,standard_charge|Aetna Health Inc|Commercial|negotiated_algorithm,estimated_amount|Aetna Health Inc|Commercial,standard_charge|Aetna Health Inc|Commercial|methodology,additional_payer_notes|Aetna Health Inc|Commercial,standard_charge|Beacon Health Options|Carelon Behavioral Health Inc|negotiated_dollar,standard_charge|Beacon Health Options|Carelon Behavioral Health Inc|negotiated_percentage,standard_charge|Beacon Health Options|Carelon Behavioral Health Inc|negotiated_algorithm,estimated_amount|Beacon Health Options|Carelon Behavioral Health Inc,standard_charge|Beacon Health Options|Carelon Behavioral Health Inc|methodology,additional_payer_notes|Beacon Health Options|Carelon Behavioral Health Inc,standard_charge|Optum UBH VA CCN|United Behavioral Health VA Community Care Program|negotiated_dollar,standard_charge|Optum UBH VA CCN|United Behavioral Health VA Community Care Program|negotiated_percentage,standard_charge|Optum UBH VA CCN|United Behavioral Health VA Community Care Program|negotiated_algorithm,estimated_amount|Optum UBH VA CCN|United Behavioral Health VA Community Care Program,standard_charge|Optum UBH VA CCN|United Behavioral Health VA Community Care Program|methodology,additional_payer_notes|Optum UBH VA CCN|United Behavioral Health VA Community Care Program,standard_charge|Magellan|Magellan Healthcare Inc|negotiated_dollar,standard_charge|Magellan|Magellan Healthcare Inc|negotiated_percentage,standard_charge|Magellan|Magellan Healthcare Inc|negotiated_algorithm,estimated_amount|Magellan|Magellan Healthcare Inc,standard_charge|Magellan|Magellan Healthcare Inc|methodology,additional_payer_notes|Magellan|Magellan Healthcare Inc,standard_charge|Midlands Choice Medica Insurance Company|Midlands Choice Inc|negotiated_dollar,standard_charge|Midlands Choice Medica Insurance Company|Midlands Choice Inc|negotiated_percentage,standard_charge|Midlands Choice Medica Insurance Company|Midlands Choice Inc|negotiated_algorithm,estimated_amount|Midlands Choice Medica Insurance Company|Midlands Choice Inc,standard_charge|Midlands Choice Medica Insurance Company|Midlands Choice Inc|methodology,additional_payer_notes|Midlands Choice Medica Insurance Company|Midlands Choice Inc,standard_charge|Mines and Assoc|Mines and Associates Inc|negotiated_dollar,standard_charge|Mines and Assoc|Mines and Associates Inc|negotiated_percentage,standard_charge|Mines and Assoc|Mines and Associates Inc|negotiated_algorithm,estimated_amount|Mines and Assoc|Mines and Associates Inc,standard_charge|Mines and Assoc|Mines and Associates Inc|methodology,additional_payer_notes|Mines and Assoc|Mines and Associates Inc,standard_charge|Quartz Health Solutions Inc|Commercial|negotiated_dollar,standard_charge|Quartz Health Solutions Inc|Commercial|negotiated_percentage,standard_charge|Quartz Health Solutions Inc|Commercial|negotiated_algorithm,estimated_amount|Quartz Health Solutions Inc|Commercial,standard_charge|Quartz Health Solutions Inc|Commercial|methodology,additional_payer_notes|Quartz Health Solutions Inc|Commercial,standard_charge|Optum UHC Behavioral|United Behavioral Health|negotiated_dollar,standard_charge|Optum UHC Behavioral|United Behavioral Health|negotiated_percentage,standard_charge|Optum UHC Behavioral|United Behavioral Health|negotiated_algorithm,estimated_amount|Optum UHC Behavioral|United Behavioral Health,standard_charge|Optum UHC Behavioral|United Behavioral Health|methodology,additional_payer_notes|Optum UHC Behavioral|United Behavioral Health,standard_charge|The Alliance|Employer Health Care Alliance Cooperative|negotiated_dollar,standard_charge|The Alliance|Employer Health Care Alliance Cooperative|negotiated_percentage,standard_charge|The Alliance|Employer Health Care Alliance Cooperative|negotiated_algorithm,estimated_amount|The Alliance|Employer Health Care Alliance Cooperative,standard_charge|The Alliance|Employer Health Care Alliance Cooperative|methodology,additional_payer_notes|The Alliance|Employer Health Care Alliance Cooperative,standard_charge|Claritev|Multiplan Inc|negotiated_dollar,standard_charge|Claritev|Multiplan Inc|negotiated_percentage,standard_charge|Claritev|Multiplan Inc|negotiated_algorithm,estimated_amount|Claritev|Multiplan Inc,standard_charge|Claritev|Multiplan Inc|methodology,additional_payer_notes|Claritev|Multiplan Inc,standard_charge|min,standard_charge|max,Additional_Generic_Notes
Inpatient Room and Board - psychiatric ,124,RC,Inpatient,,,3000,750,,1000,,,,per diem,,963.69,,,,per diem,,769,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,1200,,,,per diem,,769,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,776.69,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,769,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,900,,,,per diem,,769,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,623.7,,,,per diem,,750,,,,per diem,,834,,,,per diem,,900,,,,per diem,,777,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,769,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,769,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,1016,,,,per diem,,834,,,,per diem,,769,,,,per diem,The adjusted base rate indicated (in dollars) may be further adjusted for transfers and outliers.,1255,,,,per diem,,991,,,,per diem,,1100,,,,per diem,,1250,,,,per diem,,1026,,,,per diem,,1200,,,,per diem,,1050,,,,per diem,,500,1000,
Inpatient Room and Board - chemical dependency,126,RC,Inpatient,,,3000,750,,1000,,,,per diem,,963.69,,,,per diem,,769,,,,per diem,,1200,,,,per diem,,769,,,,per diem,,776.69,,,,per diem,,769,,,,per diem,,900,,,,per diem,,769,,,,per diem,,623.7,,,,per diem,,750,,,,per diem,,834,,,,per diem,,900,,,,per diem,,777,,,,per diem,,769,,,,per diem,,769,,,,per diem,,925,,,,per diem,,834,,,,per diem,,769,,,,per diem,,1255,,,,per diem,,991,,,,per diem,,1100,,,,per diem,,1250,,,,per diem,,1026,,,,per diem,,1200,,,,per diem,,1050,,,,Per diem,,500,1000,
Partial Hospital Program (PHP),915,RC,Outpatient,,,2500,350,,427,,,,Fee schedule,,374.89,,,,Fee schedule,,386,,,,Fee schedule,,450,,,,Fee Schedule,,386,,,,Fee Schedule,,386,,,,Fee schedule,,386,,,,Fee schedule,,225,,,,Fee schedule,,386,,,,Fee schedule,,374.89,,,,Fee schedule,,290,,,,Fee schedule,,425,,,,Fee schedule,,416,,,,Fee schedule,,389.86,,,,Fee schedule,,386,,,,Fee schedule,,386,,,,Fee schedule,,440,,,,Fee Schedule,,425,,,,Fee Schedule,,386,,,,Fee schedule,,450,,,,Fee schedule,,525,,,,Fee schedule,,550,,,,Fee schedule,,550,,,,Fee schedule,,500,,,,Fee schedule,,450,,,,Fee schedule,,550,,,,Fee Schedule,,252.28,652,
Intensive Outpatient Program (IOP) - psychiatric ,905,RC,Outpatient,,,1700,175,,220,,,,Fee schedule,,359.63,,,,Fee schedule,,252.28,,,,Fee schedule,,250,,,,Fee Schedule,,252.28,,,,Fee Schedule,,252.28,,,,Fee schedule,,252.28,,,,Fee schedule,,225,,,,Fee schedule,,252.28,,,,Fee schedule,,359.63,,,,Fee schedule,,150,,,,Fee schedule,,242,,,,Fee schedule,,260,,,,Fee schedule,,254.8,,,,Fee schedule,,252.28,,,,Fee schedule,,252.28,,,,Fee schedule,,230,,,,Fee Schedule,,242,,,,Fee Schedule,,252.28,,,,Fee schedule,,275,,,,Fee schedule,,263,,,,Fee schedule,,300,,,,Fee schedule,,350,,,,Fee schedule,,257,,,,Fee schedule,,350,,,,Fee schedule,,350,,,,Fee Schedule,,150,374,
Intensive Outpatient Program (IOP) - chemical dependency,906,RC,Outpatient,,,1700,175,,220,,,,Fee schedule,,359.63,,,,Fee schedule,,252.28,,,,Fee schedule,,250,,,,Fee Schedule,                                                                                                                                                                                                                           ,252.28,,,,Fee Schedule,,252.28,,,,Fee schedule,,252.28,,,,Fee schedule,,225,,,,Fee schedule,,252.28,,,,Fee schedule,,374.89,,,,Fee schedule,,150,,,,Fee schedule,,242,,,,Fee schedule,,260,,,,Fee schedule,,254.8,,,,Fee schedule,,252.28,,,,Fee schedule,,252.28,,,,Fee schedule,,230,,,,Fee schedule,,242,,,,Fee schedule,,252.28,,,,Fee schedule,,275,,,,Fee schedule,,263,,,,Fee schedule,,300,,,,Fee schedule,,350,,,,Fee schedule,,257,,,,Fee schedule,,350,,,,Fee schedule,,350,,,,Fee schedule,,150,374,
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