| 
                        Minor Urology Services
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.18
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00159 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.18 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.18 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.18
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Mohs Micrographic Surgery
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $1.89
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00019 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $1.89 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $1.89 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $1.89
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Monthly Behavioral Health Care And Case Management Services
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.15
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 02071 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.15 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.15 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.15
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Monthly Care And Case Management Services
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.12
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 02070 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.12 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.12 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.12
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Monthly Treatment Management Services
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.08
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 02072 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.08 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.08 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.08
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Mri Guidance
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.42
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00475 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.42 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.42 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.42
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Multiple Sclerosis And Other Demyelinating Diseases
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.24
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00523 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.24 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.24 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.24
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Musculoskeletal Excisions, Biopsies, And Drainage Procedures
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $3.80
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00051 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $3.80 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $3.80 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $3.80
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Musculoskeletal Malignancy And Pathological Fx Due To Malignancy
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.39
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00653 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.39 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.39 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.39
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Myelography And Discography Imaging Procedures
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $1.20
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00284 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $1.20 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $1.20 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $1.20
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Nail Procedures
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.14
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00005 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.14 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.14 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.14
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Nail removal partial
                     | 
                    
                        Professional
                     | 
                    
                        Both
                     | 
                    
                        $346.00
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                CPT 11730 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            1211730
                                         | 
                                     
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $41.88 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $216.84 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna Better Health CHIP/Medicaid | 
                                            
                                                $91.69
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility | 
                                            
                                                $52.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Behavioral Services Network Commercial | 
                                            
                                                $57.59
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Behavioral Services Network Medicare | 
                                            
                                                $52.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Carelon Medicare | 
                                            
                                                $52.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $41.88
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $47.12
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $49.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Magellan Medicaid | 
                                            
                                                $87.32
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Molina Complete Care Medicaid/Medicare | 
                                            
                                                $52.35
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Prime Health Services Workers Comp | 
                                            
                                                $216.84
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Nebulizer
                     | 
                    
                        Professional
                     | 
                    
                        Both
                     | 
                    
                        $33.00
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                CPT 94640 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            3194640
                                         | 
                                     
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5.98 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $11.97 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna Better Health CHIP/Medicaid | 
                                            
                                                $7.88
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility | 
                                            
                                                $7.47
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Behavioral Services Network Commercial | 
                                            
                                                $8.22
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Behavioral Services Network Medicare | 
                                            
                                                $7.47
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Carelon Medicare | 
                                            
                                                $7.47
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $7.10
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $5.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $6.72
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Magellan Medicaid | 
                                            
                                                $7.50
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Molina Complete Care Medicaid/Medicare | 
                                            
                                                $7.47
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Prime Health Services Workers Comp | 
                                            
                                                $11.97
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Neonatal Aftercare
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.39
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00873 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.39 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.39 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.39
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Neonatal Diagnoses
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.22
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00771 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.22 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.22 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.22
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Nephritis And Nephrosis
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.33
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00722 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.33 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.33 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.33
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Nerve And Muscle Tests
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.28
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00213 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.28 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.28 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.28
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Nervous System Malignancy
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.28
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00521 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.28 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.28 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.28
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Non-Bacterial Gastroenteritis, Nausea And Vomiting
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.46
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00627 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.46 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.46 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.46
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Non-Bacterial Infections Of Nervous System
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.30
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00519 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.30 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.30 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.30
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Noninvasive Ventilation Support
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.32
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 02020 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.32 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.32 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.32
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Non-Pressure Chronic Skin Ulcers
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.27
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00670 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.27 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.27 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.27
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Nonspecific Cva And Precerebral Occlusion W/O Infarc
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.25
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00534 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.25 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.25 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.25
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Normal Neonate
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.29
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00770 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.29 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.29 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.29
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Nutrition Therapy
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.47
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00118 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.47 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.47 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.47
                                             | 
                                         
                                    
                                
                             
                         
                     |