| 
                        Contusions To External Organs Other Than Head Trauma
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.56
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00610 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.56 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.56 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.56
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Corneal Tissue Processing
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $5.45
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00485 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $5.45 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $5.45 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $5.45
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Counselling Or Individual Brief Psychotherapy
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.25
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00315 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.25 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.25 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.25
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Cranial And Spinal Shunt Procedures
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $12.20
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00268 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $12.20 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $12.20 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $12.20
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Crisis Intervention
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.56
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00321 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.56 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.56 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.56
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Ct Guidance
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.16
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00473 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.16 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.16 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.16
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Cva And Precerebral Occlusion W Infarct
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.52
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00535 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.52 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.52 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.52
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        CVD risk reduction, annually, 15 mins
                     | 
                    
                        Professional
                     | 
                    
                        Both
                     | 
                    
                        $80.00
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                CPT G0446 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            57G0446
                                         | 
                                     
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $23.37 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $41.22 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility | 
                                            
                                                $29.21
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Behavioral Services Network Commercial | 
                                            
                                                $32.13
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Behavioral Services Network Medicare | 
                                            
                                                $29.21
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Carelon Medicare | 
                                            
                                                $29.21
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $27.75
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $26.29
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $23.37
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Molina Complete Care Medicaid/Medicare | 
                                            
                                                $29.21
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Prime Health Services Workers Comp | 
                                            
                                                $41.22
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Cystic Fibrosis - Pulmonary Disease
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.60
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00570 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.60 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.60 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.60
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Day Rehabilitation, Full Day
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.66
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00329 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.66 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.66 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.66
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Day Rehabilitation, Half Day
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.23
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00328 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.23 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.23 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.23
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Deep Lymph Structure Procedures
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $6.75
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00115 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6.75 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $6.75 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $6.75
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Degenerative Nervous System Diagnoses Exc Mult Sclerosis
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.27
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00522 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.27 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.27 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.27
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Dental And Oral Diagnoses And Injuries
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.30
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00563 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.30 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.30 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.30
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Dental Anesthesia
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.10
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00375 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.10 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.10 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.10
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Depression, annually
                     | 
                    
                        Professional
                     | 
                    
                        Both
                     | 
                    
                        $55.00
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                CPT G0444 
                                             | 
                                         
                                    
                                    
                                    
                                        | Hospital Charge Code | 
                                        
                                            55G0444
                                         | 
                                     
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $6.98 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $30.04 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility | 
                                            
                                                $8.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Behavioral Services Network Commercial | 
                                            
                                                $9.60
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Behavioral Services Network Medicare | 
                                            
                                                $8.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Carelon Medicare | 
                                            
                                                $8.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $8.29
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $7.86
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Lucet Commercial | 
                                            
                                                $6.98
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Molina Complete Care Medicaid/Medicare | 
                                            
                                                $8.73
                                             | 
                                         
                                    
                                        
                                            | Rate for Payer: Prime Health Services Workers Comp | 
                                            
                                                $30.04
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Depression Except Major Depressive Diagnoses
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.40
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00824 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.40 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.40 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.40
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Developmental And Neuropsychological Testing
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $1.28
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00310 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $1.28 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $1.28 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $1.28
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Diabetes With Neurologic Manifestations
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.26
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00712 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.26 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.26 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.26
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Diabetes With Ophthalmic Manifestations
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.38
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00710 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.38 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.38 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.38
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Diabetes With Other Manifestations And Complications
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.33
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00711 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.33 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.33 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.33
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Diabetes Without Complications
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.24
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00713 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.24 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.24 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.24
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Diabetes With Renal Manifestations
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.27
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00714 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.27 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.27 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.27
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Diabetes With Vascular Complications Including Foot And Other Skin Ulcers
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.28
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00715 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.28 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.28 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.28
                                             | 
                                         
                                    
                                
                             
                         
                     | 
                
            
                
                    | 
                        Diagnostic Dental Procedures
                     | 
                    
                        Facility
                     | 
                    
                        OP
                     | 
                    
                        $0.27
                     | 
                    
                        
                     | 
                
                
                    
                        
                            
                                
                                    
                                        
                                            | 
                                                Service Code
                                             | 
                                            
                                                EAPG 00376 
                                             | 
                                         
                                    
                                    
                                    
                                    
                                        
                                            | Min. Negotiated Rate | 
                                            $0.27 | 
                                         
                                    
                                    
                                        
                                            | Max. Negotiated Rate | 
                                            $0.27 | 
                                         
                                    
                                    
                                        
                                            | Rate for Payer: Sunshine Health Medicaid | 
                                            
                                                $0.27
                                             | 
                                         
                                    
                                
                             
                         
                     |