hospital_name last_updated_on version hospital_location hospital_address license_number|MI "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." "Wilmington-Treatment-Center,LLC" 12/31/2024 2.0.0 "Wilmington, North Carolina" address2520 Troy Drive license_ MHH-0961]|[plan_NC TRUE description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge]|[plan_gross standard_charge|discounted_cash standard_charge|min standard_charge]|[plan_max standard_charge|[payer_AETNA ]|[plan_HMO/PPO]|[plan_negotiated_dollar standard_charge|[payer_AETNA ]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_AETNA ]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_AETNA ]|[plan_HMO/PPO] standard_charge|[payer_AETNA ]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_AETNA ]|[plan_HMO/PPO] standard_charge|[payer_AETNA MANAGED MEDICARE ]|[plan_MANAGED MEDICARE]]|[plan_negotiated_dollar standard_charge|[payer_AETNA MANAGED MEDICARE ]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_AETNA MANAGED MEDICARE ]|[plan_MANAGED MEDICARE] 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|methodology additional_payer_notes |[payer_COMPSYCH]|[plan_HMO/PPO] standard_charge|[payer_CORE SOURCE]|[plan_HMO/PPO]]|[plan_negotiated_dollar standard_charge|[payer_CORE SOURCE]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_CORE SOURCE]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_CORE SOURCE]|[plan_HMO/PPO] standard_charge|[payer_CORE SOURCE]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_CORE SOURCE]|[plan_HMO/PPO] standard_charge|[payer_FIRST CAROLINA CARE]|[plan_HMO/PPO]]|[plan_negotiated_dollar standard_charge|[payer_FIRST CAROLINA CARE]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_FIRST CAROLINA CARE]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_FIRST CAROLINA CARE]|[plan_HMO/PPO] standard_charge|[payer_FIRST CAROLINA CARE]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_FIRST CAROLINA CARE]|[plan_HMO/PPO] standard_charge|[payer_GHI - NEW YORK]|[plan_HMO/PPO]]|[plan_negotiated_dollar 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standard_charge|[payer_MEDICARE]|[plan_MEDICARE]]|[plan_negotiated_dollar standard_charge|[payer_MEDICARE]|[plan_MEDICARE] |negotiated_percentage standard_charge|[payer_MEDICARE]|[plan_MEDICARE] |negotiated_algorithm estimated_amount|[payer_MEDICARE]|[plan_MEDICARE] standard_charge|[payer_MEDICARE]|[plan_MEDICARE] |methodology additional_payer_notes |[payer_MEDICARE]|[plan_MEDICARE] standard_charge|[payer_MERITAIN HEALTH]|[plan_HMO/PPO]]|[plan_negotiated_dollar standard_charge|[payer_MERITAIN HEALTH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_MERITAIN HEALTH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MERITAIN HEALTH]|[plan_HMO/PPO] standard_charge|[payer_MERITAIN HEALTH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_MERITAIN HEALTH]|[plan_HMO/PPO] standard_charge|[payer_OXFORD HEALTH]|[plan_HMO/PPO]]|[plan_negotiated_dollar standard_charge|[payer_OXFORD HEALTH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_OXFORD HEALTH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_OXFORD HEALTH]|[plan_HMO/PPO] standard_charge|[payer_OXFORD HEALTH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_OXFORD HEALTH]|[plan_HMO/PPO] standard_charge|[payer_RAILROAD MEDICARE]|[plan_MEDICARE PHYSICIAN]]|[plan_negotiated_dollar standard_charge|[payer_RAILROAD MEDICARE]|[plan_MEDICARE PHYSICIAN] |negotiated_percentage standard_charge|[payer_RAILROAD MEDICARE]|[plan_MEDICARE PHYSICIAN] |negotiated_algorithm estimated_amount|[payer_RAILROAD MEDICARE]|[plan_MEDICARE PHYSICIAN] standard_charge|[payer_RAILROAD MEDICARE]|[plan_MEDICARE PHYSICIAN] |methodology additional_payer_notes |[payer_RAILROAD MEDICARE]|[plan_MEDICARE PHYSICIAN] standard_charge|[payer_TRICARE EAST]|[plan_TRICARE]]|[plan_negotiated_dollar standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE EAST]|[plan_TRICARE] standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE EAST]|[plan_TRICARE] standard_charge|[payer_TRICARE FOR LIFE]|[plan_TRICARE]]|[plan_negotiated_dollar standard_charge|[payer_TRICARE FOR LIFE]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE FOR LIFE]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE FOR LIFE]|[plan_TRICARE] standard_charge|[payer_TRICARE FOR LIFE]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE FOR LIFE]|[plan_TRICARE] standard_charge|[payer_TRICARE OVERSEAS]|[plan_TRICARE]]|[plan_negotiated_dollar standard_charge|[payer_TRICARE OVERSEAS]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE OVERSEAS]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE OVERSEAS]|[plan_TRICARE] standard_charge|[payer_TRICARE OVERSEAS]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE OVERSEAS]|[plan_TRICARE] standard_charge|[payer_TRICARE WEST]|[plan_TRICARE]]|[plan_negotiated_dollar standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE WEST]|[plan_TRICARE] standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE WEST]|[plan_TRICARE] standard_charge|[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL]]|[plan_negotiated_dollar standard_charge|[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] |negotiated_percentage standard_charge|[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] standard_charge|[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] |methodology additional_payer_notes |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] standard_charge|[payer_UBH]|[plan_HMO/PPO]]|[plan_negotiated_dollar standard_charge|[payer_UBH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_UBH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UBH]|[plan_HMO/PPO] standard_charge|[payer_UBH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_UBH]|[plan_HMO/PPO] standard_charge|[payer_UBH AARP]|[plan_HMO/PPO]]|[plan_negotiated_dollar standard_charge|[payer_UBH AARP]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_UBH AARP]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UBH AARP]|[plan_HMO/PPO] standard_charge|[payer_UBH AARP]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_UBH AARP]|[plan_HMO/PPO] standard_charge|[payer_UBH MGD MCR]|[plan_MANAGED MEDICARE]]|[plan_negotiated_dollar standard_charge|[payer_UBH MGD MCR]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_UBH MGD MCR]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_UBH MGD MCR]|[plan_MANAGED MEDICARE] standard_charge|[payer_UBH MGD MCR]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_UBH MGD MCR]|[plan_MANAGED MEDICARE] standard_charge|[payer_UHC COMMUNITY PLAN]|[plan_MANAGED MEDICAID]]|[plan_negotiated_dollar standard_charge|[payer_UHC COMMUNITY PLAN]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_UHC COMMUNITY PLAN]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_UHC COMMUNITY PLAN]|[plan_MANAGED MEDICAID] standard_charge|[payer_UHC COMMUNITY PLAN]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_UHC COMMUNITY PLAN]|[plan_MANAGED MEDICAID] standard_charge|[payer_UMR]|[plan_COMMERCIAL]]|[plan_negotiated_dollar standard_charge|[payer_UMR]|[plan_COMMERCIAL] |negotiated_percentage standard_charge|[payer_UMR]|[plan_COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_UMR]|[plan_COMMERCIAL] standard_charge|[payer_UMR]|[plan_COMMERCIAL] |methodology additional_payer_notes |[payer_UMR]|[plan_COMMERCIAL] standard_charge|[payer_WELLCARE MANAGED MCD]|[plan_MANAGED MEDICAID]]|[plan_negotiated_dollar standard_charge|[payer_WELLCARE MANAGED MCD]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_WELLCARE MANAGED MCD]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_WELLCARE MANAGED MCD]|[plan_MANAGED MEDICAID] standard_charge|[payer_WELLCARE MANAGED MCD]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_WELLCARE MANAGED MCD]|[plan_MANAGED MEDICAID] standard_charge|[payer_WELLCARE MANAGED MEDICARE]|[plan_MANAGED MEDICARE]]|[plan_negotiated_dollar standard_charge|[payer_WELLCARE MANAGED MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_WELLCARE MANAGED MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_WELLCARE MANAGED MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_WELLCARE MANAGED MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_WELLCARE MANAGED MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_WORKFORCE ASSISTANCE PROG]|[plan_HMO/PPO]]|[plan_negotiated_dollar standard_charge|[payer_WORKFORCE ASSISTANCE PROG]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_WORKFORCE ASSISTANCE PROG]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_WORKFORCE ASSISTANCE PROG]|[plan_HMO/PPO] standard_charge|[payer_WORKFORCE ASSISTANCE PROG]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_WORKFORCE ASSISTANCE PROG]|[plan_HMO/PPO] standard_charge|[payer_WORTH PROJECT]|[plan_LOCAL GOVT]|[plan_negotiated_dollar standard_charge|[payer_WORTH PROJECT]|[plan_LOCAL GOVT] |negotiated_percentage standard_charge|[payer_WORTH PROJECT]|[plan_LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_WORTH PROJECT]|[plan_LOCAL GOVT] standard_charge|[payer_WORTH PROJECT]|[plan_LOCAL GOVT] |methodology additional_payer_notes |[payer_WORTH PROJECT]|[plan_LOCAL GOVT] additional_generic_notes ROOM AND BOARD DETOX 126 RC facility Inpatient 1500 1100 350 1500 1046 per diem 1046 per diem 773 per diem 350 per diem 895 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 718 per diem 796 per diem per diem 855 per diem 888 per diem 895 per diem 800 per diem 800 per diem 800 per diem 662 per diem 1046 per diem 780 per diem 633 per diem 796 per diem 895 per diem 850 per diem 1450 per diem 1007 per diem 673 per diem 1046 per diem 796 per diem 948 per diem 796 per diem 796 per diem 895 per diem 796 per diem 895 per diem 700 per diem 600 per diem 900 per diem ROOM AND BOARD REHAB 128 RC facility Inpatient 1400 1000 325 1400 888 per diem 888 per diem 677 per diem 325 per diem 895 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 589 per diem 697 per diem per diem 855 per diem 727 per diem 727 per diem 727 per diem 605 per diem 888 per diem 670 per diem 519 per diem 697 per diem 895 per diem per diem 700 per diem 881 per diem 665 per diem 697 per diem 813 per diem 697 per diem 697 per diem 697 per diem 895 per diem 700 per diem 900 per diem INTENSIVE OUTPATIENT PROGRAM WILMINGTON 906 RC facility Outpatient 400 125 123 400 212 per diem 191 per diem 191 per diem 191 per diem 191 per diem 191 per diem 191 per diem 177 per diem 198 per diem per diem 326 per diem 229 per diem 206 per diem 206 per diem 206 per diem 151 per diem 212 per diem 221 per diem 123 per diem 198 per diem 229 per diem 170 per diem 198 per diem 198 per diem PARTIAL HOSPITAL PROGRAM DAY TX 912 RC facility Outpatient 1200 735 233 1200 594 per diem 594 per diem 458 per diem 300 per diem 375 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 353 per diem 472 per diem 332 per diem per diem 469 per diem 513 per diem 421 per diem 498 per diem 498 per diem 498 per diem 332 per diem 456 per diem 594 per diem 416 per diem 233 per diem 472 per diem 332 per diem 500 per diem 332 per diem 1200 per diem 596 per diem 458 per diem 332 per diem 594 per diem 472 per diem 467 per diem 467 per diem 467 per diem 467 per diem 541 per diem 472 per diem 472 per diem 458 per diem 472 per diem 325 per diem 900 per diem PARTIAL HOSPITAL PROGRAM W/LODGING 912 RC facility Outpatient 1200 735 233 1200 594 per diem 594 per diem 458 per diem 300 per diem 375 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 560 per diem 353 per diem 472 per diem 332 per diem per diem 469 per diem 513 per diem 421 per diem 498 per diem 498 per diem 498 per diem 332 per diem 456 per diem 594 per diem 416 per diem 233 per diem 472 per diem 332 per diem 500 per diem 332 per diem 1200 per diem 596 per diem 458 per diem 332 per diem 594 per diem 472 per diem 467 per diem 467 per diem 467 per diem 467 per diem 541 per diem 472 per diem 472 per diem 458 per diem 472 per diem 325 per diem 900 per diem GROUP THERAPY 915 RC facility Outpatient 150 350 577 350 per diem ROOM AND BOARD RTC 1002 RC facility Outpatient 1300 1000 316 1300 650 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 715 per diem 461 per diem 641 per diem per diem 728 per diem 826 per diem 727 per diem 727 per diem 727 per diem 665 per diem 316 per diem 700 per diem 743 per diem 655 per diem 584 per diem 641 per diem 325 per diem 900 per diem 90833 ADD ON 30 MIN 5204 RC facility Outpatient 104 62 57 69 per diem 62 per diem 69 per diem 62 per diem 62 per diem 62 per diem 62 per diem 62 per diem 62 per diem 62 per diem 69 per diem 60 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 62 per diem 69 per diem 69 per diem 62 per diem 60 per diem 62 per diem 62 per diem 62 per diem 99221 INITIAL PARTIAL HOSPITAL PROGRAM 5212 RC facility Outpatient 166 97 97 111 78 per diem 97 per diem 111 per diem 111 per diem 111 per diem 111 per diem 111 per diem 111 per diem 111 per diem 97 per diem 97 per diem 97 per diem 97 per diem 97 per diem 97 per diem 97 per diem 97 per diem 97 per diem 97 per diem 78 per diem 97 per diem 78 per diem 78 per diem 78 per diem 99222 INTL PARTIAL HOSPITAL PROGRAM MOD 5213 RC facility Outpatient 224 131 131 153 124 per diem 132 per diem 153 per diem 153 per diem 153 per diem 153 per diem 153 per diem 153 per diem 153 per diem 132 per diem 131 per diem 132 per diem 132 per diem 132 per diem 132 per diem 132 per diem 131 per diem 132 per diem 132 per diem 124 per diem 131 per diem 124 per diem 124 per diem 124 per diem 99223 INTL PARTIAL HOSPITAL PROGRAM HIGH 5214 RC facility Outpatient 332 192 192 225 164 per diem 194 per diem 225 per diem 225 per diem 225 per diem 225 per diem 225 per diem 225 per diem 225 per diem 194 per diem 168 per diem 194 per diem 194 per diem 194 per diem 194 per diem 194 per diem 192 per diem 194 per diem 194 per diem 164 per diem 168 per diem 164 per diem 164 per diem 164 per diem 99231 SUBSEQUENT PARTIAL HOSPITAL PROGRAM 5215 RC facility Outpatient 64 37 37 46 46 per diem 37 per diem 46 per diem 46 per diem 46 per diem 46 per diem 46 per diem 46 per diem 46 per diem 37 per diem 48 per diem 37 per diem 37 per diem 37 per diem 37 per diem 37 per diem 37 per diem 37 per diem 37 per diem 46 per diem 48 per diem 46 per diem 46 per diem 46 per diem 99232 SUB HOS MODERA 5216 RC facility Outpatient 119 69 69 83 75 per diem 69 per diem 83 per diem 83 per diem 83 per diem 83 per diem 83 per diem 83 per diem 83 per diem 69 per diem 76 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 75 per diem 76 per diem 75 per diem 75 per diem 75 per diem 99233 SUB PARTIAL HOSPITAL PROGRAM HIGH 5217 RC facility Outpatient 171 99 99 119 112 per diem 100 per diem 119 per diem 119 per diem 119 per diem 119 per diem 119 per diem 119 per diem 119 per diem 100 per diem 115 per diem 100 per diem 100 per diem 100 per diem 100 per diem 100 per diem 99 per diem 100 per diem 100 per diem 112 per diem 115 per diem 112 per diem 112 per diem 112 per diem 99238 D/C HOS LOW 5218 RC facility Outpatient 120 69 68 84 77 per diem 69 per diem 84 per diem 84 per diem 84 per diem 84 per diem 84 per diem 84 per diem 84 per diem 69 per diem 78 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 69 per diem 77 per diem 78 per diem 77 per diem 77 per diem 77 per diem 99239 D/C PARTIAL HOSPITAL PROGRAM >30 MI 5219 RC facility Outpatient 177 101 101 121 108 per diem 103 per diem 121 per diem 121 per diem 121 per diem 121 per diem 121 per diem 121 per diem 121 per diem 103 per diem 101 per diem 103 per diem 103 per diem 103 per diem 103 per diem 103 per diem 101 per diem 103 per diem 103 per diem 108 per diem 101 per diem 108 per diem 108 per diem 108 per diem