intensive outpatient/partial hospitalization liability tables...allegheny intensive...
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Ada
ms
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,740 $2,262 $2,784 $3,306 $3,828 $4,350 $4,3502 $2,359 $3,067 $3,775 $4,483 $5,190 $5,898 $5,8983 $2,978 $3,872 $4,766 $5,659 $6,553 $7,446 $7,4464 $3,598 $4,677 $5,756 $6,836 $7,915 $8,994 $8,9945 $4,217 $5,482 $6,747 $8,012 $9,277 $10,542 $10,5426 $4,836 $6,287 $7,738 $9,189 $10,639 $12,090 $12,0907 $5,455 $7,092 $8,728 $10,365 $12,002 $13,638 $13,6388 $6,074 $7,897 $9,719 $11,541 $13,364 $15,186 $15,1869 $6,694 $8,702 $10,710 $12,718 $14,726 $16,734 $16,734
10 $7,313 $9,507 $11,701 $13,894 $16,088 $18,282 $18,282
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Alle
ghen
y
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,811 $2,354 $2,897 $3,441 $3,984 $4,527 $4,5272 $2,455 $3,192 $3,928 $4,665 $5,402 $6,138 $6,1383 $3,100 $4,030 $4,959 $5,889 $6,819 $7,749 $7,7494 $3,744 $4,867 $5,991 $7,114 $8,237 $9,360 $9,3605 $4,388 $5,705 $7,022 $8,338 $9,655 $10,971 $10,9716 $5,033 $6,543 $8,053 $9,562 $11,072 $12,582 $12,5827 $5,677 $7,380 $9,084 $10,787 $12,490 $14,193 $14,1938 $6,322 $8,218 $10,115 $12,011 $13,908 $15,804 $15,8049 $6,966 $9,056 $11,146 $13,236 $15,325 $17,415 $17,415
10 $7,610 $9,894 $12,177 $14,460 $16,743 $19,026 $19,026
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Arm
stro
ng
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,639 $2,131 $2,622 $3,114 $3,606 $4,097 $4,0972 $2,222 $2,889 $3,555 $4,222 $4,889 $5,555 $5,5553 $2,805 $3,647 $4,488 $5,330 $6,172 $7,013 $7,0134 $3,389 $4,405 $5,422 $6,438 $7,455 $8,471 $8,4715 $3,972 $5,163 $6,355 $7,546 $8,738 $9,929 $9,9296 $4,555 $5,921 $7,288 $8,654 $10,021 $11,387 $11,3877 $5,138 $6,680 $8,221 $9,762 $11,304 $12,845 $12,8458 $5,721 $7,438 $9,154 $10,870 $12,587 $14,303 $14,3039 $6,305 $8,196 $10,087 $11,979 $13,870 $15,761 $15,761
10 $6,888 $8,954 $11,020 $13,087 $15,153 $17,219 $17,219
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Bea
ver
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,700 $2,209 $2,719 $3,229 $3,739 $4,249 $4,2492 $2,304 $2,996 $3,687 $4,378 $5,070 $5,761 $5,7613 $2,909 $3,782 $4,655 $5,527 $6,400 $7,273 $7,2734 $3,514 $4,568 $5,622 $6,677 $7,731 $8,785 $8,7855 $4,119 $5,354 $6,590 $7,826 $9,061 $10,297 $10,2976 $4,724 $6,141 $7,558 $8,975 $10,392 $11,809 $11,8097 $5,328 $6,927 $8,525 $10,124 $11,722 $13,321 $13,3218 $5,933 $7,713 $9,493 $11,273 $13,053 $14,833 $14,8339 $6,538 $8,499 $10,461 $12,422 $14,384 $16,345 $16,345
10 $7,143 $9,286 $11,428 $13,571 $15,714 $17,857 $17,857
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Bed
ford
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,609 $2,091 $2,574 $3,056 $3,539 $4,021 $4,0212 $2,181 $2,835 $3,490 $4,144 $4,798 $5,452 $5,4523 $2,753 $3,579 $4,405 $5,231 $6,057 $6,883 $6,8834 $3,326 $4,323 $5,321 $6,319 $7,317 $8,314 $8,3145 $3,898 $5,068 $6,237 $7,406 $8,576 $9,745 $9,7456 $4,471 $5,812 $7,153 $8,494 $9,835 $11,176 $11,1767 $5,043 $6,556 $8,069 $9,582 $11,094 $12,607 $12,6078 $5,615 $7,300 $8,985 $10,669 $12,354 $14,038 $14,0389 $6,188 $8,044 $9,900 $11,757 $13,613 $15,469 $15,469
10 $6,760 $8,788 $10,816 $12,844 $14,872 $16,900 $16,900
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Ber
ks
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,831 $2,380 $2,930 $3,479 $4,028 $4,578 $4,5782 $2,483 $3,228 $3,972 $4,717 $5,462 $6,207 $6,2073 $3,134 $4,075 $5,015 $5,955 $6,895 $7,836 $7,8364 $3,786 $4,922 $6,057 $7,193 $8,329 $9,465 $9,4655 $4,438 $5,769 $7,100 $8,431 $9,763 $11,094 $11,0946 $5,089 $6,616 $8,143 $9,669 $11,196 $12,723 $12,7237 $5,741 $7,463 $9,185 $10,907 $12,630 $14,352 $14,3528 $6,392 $8,310 $10,228 $12,145 $14,063 $15,981 $15,9819 $7,044 $9,157 $11,270 $13,383 $15,497 $17,610 $17,610
10 $7,696 $10,004 $12,313 $14,621 $16,930 $19,239 $19,239
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Bla
ir
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,619 $2,104 $2,590 $3,075 $3,561 $4,047 $4,0472 $2,195 $2,853 $3,511 $4,170 $4,828 $5,487 $5,4873 $2,771 $3,602 $4,433 $5,264 $6,095 $6,927 $6,9274 $3,347 $4,351 $5,355 $6,359 $7,363 $8,367 $8,3675 $3,923 $5,099 $6,276 $7,453 $8,630 $9,807 $9,8076 $4,499 $5,848 $7,198 $8,547 $9,897 $11,247 $11,2477 $5,075 $6,597 $8,119 $9,642 $11,164 $12,687 $12,6878 $5,651 $7,346 $9,041 $10,736 $12,431 $14,127 $14,1279 $6,227 $8,095 $9,963 $11,831 $13,699 $15,567 $15,567
10 $6,803 $8,843 $10,884 $12,925 $14,966 $17,007 $17,007
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Bra
dfor
d
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,609 $2,091 $2,574 $3,056 $3,539 $4,021 $4,0212 $2,181 $2,835 $3,490 $4,144 $4,798 $5,452 $5,4523 $2,753 $3,579 $4,405 $5,231 $6,057 $6,883 $6,8834 $3,326 $4,323 $5,321 $6,319 $7,317 $8,314 $8,3145 $3,898 $5,068 $6,237 $7,406 $8,576 $9,745 $9,7456 $4,471 $5,812 $7,153 $8,494 $9,835 $11,176 $11,1767 $5,043 $6,556 $8,069 $9,582 $11,094 $12,607 $12,6078 $5,615 $7,300 $8,985 $10,669 $12,354 $14,038 $14,0389 $6,188 $8,044 $9,900 $11,757 $13,613 $15,469 $15,469
10 $6,760 $8,788 $10,816 $12,844 $14,872 $16,900 $16,900
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Buc
ks
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $2,600 $3,380 $4,160 $4,940 $5,720 $6,500 $6,5002 $3,525 $4,583 $5,640 $6,698 $7,755 $8,813 $8,8133 $4,450 $5,785 $7,121 $8,456 $9,791 $11,126 $11,1264 $5,376 $6,988 $8,601 $10,214 $11,826 $13,439 $13,4395 $6,301 $8,191 $10,081 $11,971 $13,862 $15,752 $15,7526 $7,226 $9,394 $11,562 $13,729 $15,897 $18,065 $18,0657 $8,151 $10,597 $13,042 $15,487 $17,933 $20,378 $20,3788 $9,076 $11,799 $14,522 $17,245 $19,968 $22,691 $22,6919 $10,002 $13,002 $16,003 $19,003 $22,003 $25,004 $25,004
10 $10,927 $14,205 $17,483 $20,761 $24,039 $27,317 $27,317
Client Liability: 0% 10% 20% 30% 40% 50% 100%
But
ler
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,841 $2,394 $2,946 $3,498 $4,051 $4,603 $4,6032 $2,496 $3,245 $3,994 $4,743 $5,492 $6,241 $6,2413 $3,152 $4,097 $5,043 $5,988 $6,934 $7,879 $7,8794 $3,807 $4,949 $6,091 $7,233 $8,375 $9,517 $9,5175 $4,462 $5,801 $7,139 $8,478 $9,816 $11,155 $11,1556 $5,117 $6,652 $8,188 $9,723 $11,258 $12,793 $12,7937 $5,772 $7,504 $9,236 $10,968 $12,699 $14,431 $14,4318 $6,428 $8,356 $10,284 $12,213 $14,141 $16,069 $16,0699 $7,083 $9,208 $11,333 $13,457 $15,582 $17,707 $17,707
10 $7,738 $10,059 $12,381 $14,702 $17,024 $19,345 $19,345
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Cam
bria
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,558 $2,025 $2,493 $2,960 $3,428 $3,895 $3,8952 $2,112 $2,746 $3,380 $4,013 $4,647 $5,281 $5,2813 $2,667 $3,467 $4,267 $5,067 $5,867 $6,667 $6,6674 $3,221 $4,188 $5,154 $6,120 $7,087 $8,053 $8,0535 $3,776 $4,908 $6,041 $7,174 $8,306 $9,439 $9,4396 $4,330 $5,629 $6,928 $8,227 $9,526 $10,825 $10,8257 $4,884 $6,350 $7,815 $9,280 $10,746 $12,211 $12,2118 $5,439 $7,070 $8,702 $10,334 $11,965 $13,597 $13,5979 $5,993 $7,791 $9,589 $11,387 $13,185 $14,983 $14,983
10 $6,548 $8,512 $10,476 $12,440 $14,405 $16,369 $16,369
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Cam
eron
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,598 $2,078 $2,557 $3,037 $3,517 $3,996 $3,9962 $2,167 $2,817 $3,468 $4,118 $4,768 $5,418 $5,4183 $2,736 $3,557 $4,378 $5,198 $6,019 $6,840 $6,8404 $3,305 $4,296 $5,288 $6,279 $7,271 $8,262 $8,2625 $3,874 $5,036 $6,198 $7,360 $8,522 $9,684 $9,6846 $4,442 $5,775 $7,108 $8,441 $9,773 $11,106 $11,1067 $5,011 $6,515 $8,018 $9,521 $11,025 $12,528 $12,5288 $5,580 $7,254 $8,928 $10,602 $12,276 $13,950 $13,9509 $6,149 $7,993 $9,838 $11,683 $13,527 $15,372 $15,372
10 $6,718 $8,733 $10,748 $12,764 $14,779 $16,794 $16,794
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Car
bon
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,700 $2,209 $2,719 $3,229 $3,739 $4,249 $4,2492 $2,304 $2,996 $3,687 $4,378 $5,070 $5,761 $5,7613 $2,909 $3,782 $4,655 $5,527 $6,400 $7,273 $7,2734 $3,514 $4,568 $5,622 $6,677 $7,731 $8,785 $8,7855 $4,119 $5,354 $6,590 $7,826 $9,061 $10,297 $10,2976 $4,724 $6,141 $7,558 $8,975 $10,392 $11,809 $11,8097 $5,328 $6,927 $8,525 $10,124 $11,722 $13,321 $13,3218 $5,933 $7,713 $9,493 $11,273 $13,053 $14,833 $14,8339 $6,538 $8,499 $10,461 $12,422 $14,384 $16,345 $16,345
10 $7,143 $9,286 $11,428 $13,571 $15,714 $17,857 $17,857
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Cen
tre
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,953 $2,538 $3,124 $3,710 $4,296 $4,881 $4,8812 $2,647 $3,442 $4,236 $5,030 $5,824 $6,618 $6,6183 $3,342 $4,345 $5,347 $6,350 $7,353 $8,355 $8,3554 $4,037 $5,248 $6,459 $7,670 $8,881 $10,092 $10,0925 $4,732 $6,151 $7,571 $8,990 $10,410 $11,829 $11,8296 $5,427 $7,054 $8,682 $10,310 $11,938 $13,566 $13,5667 $6,121 $7,958 $9,794 $11,631 $13,467 $15,303 $15,3038 $6,816 $8,861 $10,906 $12,951 $14,995 $17,040 $17,0409 $7,511 $9,764 $12,017 $14,271 $16,524 $18,777 $18,777
10 $8,206 $10,667 $13,129 $15,591 $18,053 $20,514 $20,514
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Che
ster
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $2,630 $3,419 $4,209 $4,998 $5,787 $6,576 $6,5762 $3,566 $4,636 $5,706 $6,776 $7,846 $8,916 $8,9163 $4,502 $5,853 $7,204 $8,554 $9,905 $11,256 $11,2564 $5,438 $7,070 $8,701 $10,333 $11,964 $13,596 $13,5965 $6,374 $8,287 $10,199 $12,111 $14,024 $15,936 $15,9366 $7,310 $9,503 $11,697 $13,890 $16,083 $18,276 $18,2767 $8,246 $10,720 $13,194 $15,668 $18,142 $20,616 $20,6168 $9,182 $11,937 $14,692 $17,446 $20,201 $22,956 $22,9569 $10,118 $13,154 $16,189 $19,225 $22,260 $25,296 $25,296
10 $11,054 $14,371 $17,687 $21,003 $24,320 $27,636 $27,636
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Cla
rion
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,639 $2,131 $2,622 $3,114 $3,606 $4,097 $4,0972 $2,222 $2,889 $3,555 $4,222 $4,889 $5,555 $5,5553 $2,805 $3,647 $4,488 $5,330 $6,172 $7,013 $7,0134 $3,389 $4,405 $5,422 $6,438 $7,455 $8,471 $8,4715 $3,972 $5,163 $6,355 $7,546 $8,738 $9,929 $9,9296 $4,555 $5,921 $7,288 $8,654 $10,021 $11,387 $11,3877 $5,138 $6,680 $8,221 $9,762 $11,304 $12,845 $12,8458 $5,721 $7,438 $9,154 $10,870 $12,587 $14,303 $14,3039 $6,305 $8,196 $10,087 $11,979 $13,870 $15,761 $15,761
10 $6,888 $8,954 $11,020 $13,087 $15,153 $17,219 $17,219
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Cle
arfie
ld
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,568 $2,039 $2,509 $2,979 $3,450 $3,920 $3,9202 $2,126 $2,764 $3,402 $4,040 $4,677 $5,315 $5,3153 $2,684 $3,489 $4,295 $5,100 $5,905 $6,710 $6,7104 $3,242 $4,215 $5,187 $6,160 $7,133 $8,105 $8,1055 $3,800 $4,940 $6,080 $7,220 $8,360 $9,500 $9,5006 $4,358 $5,666 $6,973 $8,280 $9,588 $10,895 $10,8957 $4,916 $6,391 $7,866 $9,341 $10,815 $12,290 $12,2908 $5,474 $7,116 $8,759 $10,401 $12,043 $13,685 $13,6859 $6,032 $7,842 $9,651 $11,461 $13,271 $15,080 $15,080
10 $6,590 $8,567 $10,544 $12,521 $14,498 $16,475 $16,475
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Clin
ton
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,629 $2,117 $2,606 $3,095 $3,583 $4,072 $4,0722 $2,208 $2,871 $3,533 $4,196 $4,858 $5,521 $5,5213 $2,788 $3,624 $4,461 $5,297 $6,134 $6,970 $6,9704 $3,368 $4,378 $5,388 $6,398 $7,409 $8,419 $8,4195 $3,947 $5,131 $6,315 $7,500 $8,684 $9,868 $9,8686 $4,527 $5,885 $7,243 $8,601 $9,959 $11,317 $11,3177 $5,106 $6,638 $8,170 $9,702 $11,234 $12,766 $12,7668 $5,686 $7,392 $9,098 $10,803 $12,509 $14,215 $14,2159 $6,266 $8,145 $10,025 $11,905 $13,784 $15,664 $15,664
10 $6,845 $8,899 $10,952 $13,006 $15,059 $17,113 $17,113
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Col
umbi
a
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,609 $2,091 $2,574 $3,056 $3,539 $4,021 $4,0212 $2,181 $2,835 $3,490 $4,144 $4,798 $5,452 $5,4523 $2,753 $3,579 $4,405 $5,231 $6,057 $6,883 $6,8834 $3,326 $4,323 $5,321 $6,319 $7,317 $8,314 $8,3145 $3,898 $5,068 $6,237 $7,406 $8,576 $9,745 $9,7456 $4,471 $5,812 $7,153 $8,494 $9,835 $11,176 $11,1767 $5,043 $6,556 $8,069 $9,582 $11,094 $12,607 $12,6078 $5,615 $7,300 $8,985 $10,669 $12,354 $14,038 $14,0389 $6,188 $8,044 $9,900 $11,757 $13,613 $15,469 $15,469
10 $6,760 $8,788 $10,816 $12,844 $14,872 $16,900 $16,900
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Cra
wfo
rd
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,629 $2,117 $2,606 $3,095 $3,583 $4,072 $4,0722 $2,208 $2,871 $3,533 $4,196 $4,858 $5,521 $5,5213 $2,788 $3,624 $4,461 $5,297 $6,134 $6,970 $6,9704 $3,368 $4,378 $5,388 $6,398 $7,409 $8,419 $8,4195 $3,947 $5,131 $6,315 $7,500 $8,684 $9,868 $9,8686 $4,527 $5,885 $7,243 $8,601 $9,959 $11,317 $11,3177 $5,106 $6,638 $8,170 $9,702 $11,234 $12,766 $12,7668 $5,686 $7,392 $9,098 $10,803 $12,509 $14,215 $14,2159 $6,266 $8,145 $10,025 $11,905 $13,784 $15,664 $15,664
10 $6,845 $8,899 $10,952 $13,006 $15,059 $17,113 $17,113
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Cum
berla
nd
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,831 $2,380 $2,930 $3,479 $4,028 $4,578 $4,5782 $2,483 $3,228 $3,972 $4,717 $5,462 $6,207 $6,2073 $3,134 $4,075 $5,015 $5,955 $6,895 $7,836 $7,8364 $3,786 $4,922 $6,057 $7,193 $8,329 $9,465 $9,4655 $4,438 $5,769 $7,100 $8,431 $9,763 $11,094 $11,0946 $5,089 $6,616 $8,143 $9,669 $11,196 $12,723 $12,7237 $5,741 $7,463 $9,185 $10,907 $12,630 $14,352 $14,3528 $6,392 $8,310 $10,228 $12,145 $14,063 $15,981 $15,9819 $7,044 $9,157 $11,270 $13,383 $15,497 $17,610 $17,610
10 $7,696 $10,004 $12,313 $14,621 $16,930 $19,239 $19,239
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Dau
phin
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,831 $2,380 $2,930 $3,479 $4,028 $4,578 $4,5782 $2,483 $3,228 $3,972 $4,717 $5,462 $6,207 $6,2073 $3,134 $4,075 $5,015 $5,955 $6,895 $7,836 $7,8364 $3,786 $4,922 $6,057 $7,193 $8,329 $9,465 $9,4655 $4,438 $5,769 $7,100 $8,431 $9,763 $11,094 $11,0946 $5,089 $6,616 $8,143 $9,669 $11,196 $12,723 $12,7237 $5,741 $7,463 $9,185 $10,907 $12,630 $14,352 $14,3528 $6,392 $8,310 $10,228 $12,145 $14,063 $15,981 $15,9819 $7,044 $9,157 $11,270 $13,383 $15,497 $17,610 $17,610
10 $7,696 $10,004 $12,313 $14,621 $16,930 $19,239 $19,239
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Del
awar
e
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $2,357 $3,064 $3,771 $4,479 $5,186 $5,893 $5,8932 $3,196 $4,155 $5,114 $6,072 $7,031 $7,990 $7,9903 $4,035 $5,245 $6,456 $7,666 $8,877 $10,087 $10,0874 $4,874 $6,336 $7,798 $9,260 $10,722 $12,184 $12,1845 $5,712 $7,426 $9,140 $10,854 $12,567 $14,281 $14,2816 $6,551 $8,517 $10,482 $12,447 $14,413 $16,378 $16,3787 $7,390 $9,607 $11,824 $14,041 $16,258 $18,475 $18,4758 $8,229 $10,697 $13,166 $15,635 $18,103 $20,572 $20,5729 $9,068 $11,788 $14,508 $17,228 $19,949 $22,669 $22,669
10 $9,906 $12,878 $15,850 $18,822 $21,794 $24,766 $24,766
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Elk
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,598 $2,078 $2,557 $3,037 $3,517 $3,996 $3,9962 $2,167 $2,817 $3,468 $4,118 $4,768 $5,418 $5,4183 $2,736 $3,557 $4,378 $5,198 $6,019 $6,840 $6,8404 $3,305 $4,296 $5,288 $6,279 $7,271 $8,262 $8,2625 $3,874 $5,036 $6,198 $7,360 $8,522 $9,684 $9,6846 $4,442 $5,775 $7,108 $8,441 $9,773 $11,106 $11,1067 $5,011 $6,515 $8,018 $9,521 $11,025 $12,528 $12,5288 $5,580 $7,254 $8,928 $10,602 $12,276 $13,950 $13,9509 $6,149 $7,993 $9,838 $11,683 $13,527 $15,372 $15,372
10 $6,718 $8,733 $10,748 $12,764 $14,779 $16,794 $16,794
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Erie
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,619 $2,104 $2,590 $3,075 $3,561 $4,047 $4,0472 $2,195 $2,853 $3,511 $4,170 $4,828 $5,487 $5,4873 $2,771 $3,602 $4,433 $5,264 $6,095 $6,927 $6,9274 $3,347 $4,351 $5,355 $6,359 $7,363 $8,367 $8,3675 $3,923 $5,099 $6,276 $7,453 $8,630 $9,807 $9,8076 $4,499 $5,848 $7,198 $8,547 $9,897 $11,247 $11,2477 $5,075 $6,597 $8,119 $9,642 $11,164 $12,687 $12,6878 $5,651 $7,346 $9,041 $10,736 $12,431 $14,127 $14,1279 $6,227 $8,095 $9,963 $11,831 $13,699 $15,567 $15,567
10 $6,803 $8,843 $10,884 $12,925 $14,966 $17,007 $17,007
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Faye
tte
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,568 $2,039 $2,509 $2,979 $3,450 $3,920 $3,9202 $2,126 $2,764 $3,402 $4,040 $4,677 $5,315 $5,3153 $2,684 $3,489 $4,295 $5,100 $5,905 $6,710 $6,7104 $3,242 $4,215 $5,187 $6,160 $7,133 $8,105 $8,1055 $3,800 $4,940 $6,080 $7,220 $8,360 $9,500 $9,5006 $4,358 $5,666 $6,973 $8,280 $9,588 $10,895 $10,8957 $4,916 $6,391 $7,866 $9,341 $10,815 $12,290 $12,2908 $5,474 $7,116 $8,759 $10,401 $12,043 $13,685 $13,6859 $6,032 $7,842 $9,651 $11,461 $13,271 $15,080 $15,080
10 $6,590 $8,567 $10,544 $12,521 $14,498 $16,475 $16,475
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Fore
st
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,629 $2,117 $2,606 $3,095 $3,583 $4,072 $4,0722 $2,208 $2,871 $3,533 $4,196 $4,858 $5,521 $5,5213 $2,788 $3,624 $4,461 $5,297 $6,134 $6,970 $6,9704 $3,368 $4,378 $5,388 $6,398 $7,409 $8,419 $8,4195 $3,947 $5,131 $6,315 $7,500 $8,684 $9,868 $9,8686 $4,527 $5,885 $7,243 $8,601 $9,959 $11,317 $11,3177 $5,106 $6,638 $8,170 $9,702 $11,234 $12,766 $12,7668 $5,686 $7,392 $9,098 $10,803 $12,509 $14,215 $14,2159 $6,266 $8,145 $10,025 $11,905 $13,784 $15,664 $15,664
10 $6,845 $8,899 $10,952 $13,006 $15,059 $17,113 $17,113
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Fran
klin
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,619 $2,104 $2,590 $3,075 $3,561 $4,047 $4,0472 $2,195 $2,853 $3,511 $4,170 $4,828 $5,487 $5,4873 $2,771 $3,602 $4,433 $5,264 $6,095 $6,927 $6,9274 $3,347 $4,351 $5,355 $6,359 $7,363 $8,367 $8,3675 $3,923 $5,099 $6,276 $7,453 $8,630 $9,807 $9,8076 $4,499 $5,848 $7,198 $8,547 $9,897 $11,247 $11,2477 $5,075 $6,597 $8,119 $9,642 $11,164 $12,687 $12,6878 $5,651 $7,346 $9,041 $10,736 $12,431 $14,127 $14,1279 $6,227 $8,095 $9,963 $11,831 $13,699 $15,567 $15,567
10 $6,803 $8,843 $10,884 $12,925 $14,966 $17,007 $17,007
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Fulto
n
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,578 $2,052 $2,525 $2,999 $3,472 $3,946 $3,9462 $2,140 $2,782 $3,424 $4,066 $4,708 $5,350 $5,3503 $2,701 $3,512 $4,322 $5,133 $5,943 $6,754 $6,7544 $3,263 $4,242 $5,221 $6,200 $7,179 $8,158 $8,1585 $3,825 $4,972 $6,119 $7,267 $8,414 $9,562 $9,5626 $4,386 $5,702 $7,018 $8,334 $9,650 $10,966 $10,9667 $4,948 $6,432 $7,916 $9,401 $10,885 $12,370 $12,3708 $5,509 $7,162 $8,815 $10,468 $12,121 $13,774 $13,7749 $6,071 $7,892 $9,714 $11,535 $13,356 $15,178 $15,178
10 $6,633 $8,622 $10,612 $12,602 $14,592 $16,582 $16,582
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Gre
ene
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,619 $2,104 $2,590 $3,075 $3,561 $4,047 $4,0472 $2,195 $2,853 $3,511 $4,170 $4,828 $5,487 $5,4873 $2,771 $3,602 $4,433 $5,264 $6,095 $6,927 $6,9274 $3,347 $4,351 $5,355 $6,359 $7,363 $8,367 $8,3675 $3,923 $5,099 $6,276 $7,453 $8,630 $9,807 $9,8076 $4,499 $5,848 $7,198 $8,547 $9,897 $11,247 $11,2477 $5,075 $6,597 $8,119 $9,642 $11,164 $12,687 $12,6878 $5,651 $7,346 $9,041 $10,736 $12,431 $14,127 $14,1279 $6,227 $8,095 $9,963 $11,831 $13,699 $15,567 $15,567
10 $6,803 $8,843 $10,884 $12,925 $14,966 $17,007 $17,007
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Hun
tingd
on
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,548 $2,012 $2,477 $2,941 $3,405 $3,870 $3,8702 $2,099 $2,728 $3,358 $3,987 $4,617 $5,247 $5,2473 $2,649 $3,444 $4,239 $5,034 $5,829 $6,624 $6,6244 $3,200 $4,160 $5,120 $6,080 $7,041 $8,001 $8,0015 $3,751 $4,876 $6,002 $7,127 $8,252 $9,378 $9,3786 $4,302 $5,592 $6,883 $8,174 $9,464 $10,755 $10,7557 $4,853 $6,308 $7,764 $9,220 $10,676 $12,132 $12,1328 $5,403 $7,024 $8,646 $10,267 $11,888 $13,509 $13,5099 $5,954 $7,741 $9,527 $11,313 $13,099 $14,886 $14,886
10 $6,505 $8,457 $10,408 $12,360 $14,311 $16,263 $16,263
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Indi
ana
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,639 $2,131 $2,622 $3,114 $3,606 $4,097 $4,0972 $2,222 $2,889 $3,555 $4,222 $4,889 $5,555 $5,5553 $2,805 $3,647 $4,488 $5,330 $6,172 $7,013 $7,0134 $3,389 $4,405 $5,422 $6,438 $7,455 $8,471 $8,4715 $3,972 $5,163 $6,355 $7,546 $8,738 $9,929 $9,9296 $4,555 $5,921 $7,288 $8,654 $10,021 $11,387 $11,3877 $5,138 $6,680 $8,221 $9,762 $11,304 $12,845 $12,8458 $5,721 $7,438 $9,154 $10,870 $12,587 $14,303 $14,3039 $6,305 $8,196 $10,087 $11,979 $13,870 $15,761 $15,761
10 $6,888 $8,954 $11,020 $13,087 $15,153 $17,219 $17,219
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Jeffe
rson
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,568 $2,039 $2,509 $2,979 $3,450 $3,920 $3,9202 $2,126 $2,764 $3,402 $4,040 $4,677 $5,315 $5,3153 $2,684 $3,489 $4,295 $5,100 $5,905 $6,710 $6,7104 $3,242 $4,215 $5,187 $6,160 $7,133 $8,105 $8,1055 $3,800 $4,940 $6,080 $7,220 $8,360 $9,500 $9,5006 $4,358 $5,666 $6,973 $8,280 $9,588 $10,895 $10,8957 $4,916 $6,391 $7,866 $9,341 $10,815 $12,290 $12,2908 $5,474 $7,116 $8,759 $10,401 $12,043 $13,685 $13,6859 $6,032 $7,842 $9,651 $11,461 $13,271 $15,080 $15,080
10 $6,590 $8,567 $10,544 $12,521 $14,498 $16,475 $16,475
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Juni
ata
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,548 $2,012 $2,477 $2,941 $3,405 $3,870 $3,8702 $2,099 $2,728 $3,358 $3,987 $4,617 $5,247 $5,2473 $2,649 $3,444 $4,239 $5,034 $5,829 $6,624 $6,6244 $3,200 $4,160 $5,120 $6,080 $7,041 $8,001 $8,0015 $3,751 $4,876 $6,002 $7,127 $8,252 $9,378 $9,3786 $4,302 $5,592 $6,883 $8,174 $9,464 $10,755 $10,7557 $4,853 $6,308 $7,764 $9,220 $10,676 $12,132 $12,1328 $5,403 $7,024 $8,646 $10,267 $11,888 $13,509 $13,5099 $5,954 $7,741 $9,527 $11,313 $13,099 $14,886 $14,886
10 $6,505 $8,457 $10,408 $12,360 $14,311 $16,263 $16,263
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Lack
awan
na
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,730 $2,249 $2,768 $3,287 $3,806 $4,325 $4,3252 $2,346 $3,049 $3,753 $4,457 $5,160 $5,864 $5,8643 $2,961 $3,849 $4,738 $5,626 $6,515 $7,403 $7,4034 $3,577 $4,650 $5,723 $6,796 $7,869 $8,942 $8,9425 $4,192 $5,450 $6,708 $7,965 $9,223 $10,481 $10,4816 $4,808 $6,250 $7,693 $9,135 $10,577 $12,020 $12,0207 $5,424 $7,051 $8,678 $10,305 $11,932 $13,559 $13,5598 $6,039 $7,851 $9,663 $11,474 $13,286 $15,098 $15,0989 $6,655 $8,651 $10,648 $12,644 $14,640 $16,637 $16,637
10 $7,270 $9,451 $11,633 $13,814 $15,995 $18,176 $18,176
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Lanc
aste
r
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,791 $2,328 $2,865 $3,402 $3,939 $4,477 $4,4772 $2,428 $3,156 $3,885 $4,613 $5,341 $6,070 $6,0703 $3,065 $3,985 $4,904 $5,824 $6,743 $7,663 $7,6634 $3,702 $4,813 $5,924 $7,034 $8,145 $9,256 $9,2565 $4,339 $5,641 $6,943 $8,245 $9,547 $10,849 $10,8496 $4,977 $6,470 $7,963 $9,456 $10,949 $12,442 $12,4427 $5,614 $7,298 $8,982 $10,666 $12,350 $14,035 $14,0358 $6,251 $8,126 $10,002 $11,877 $13,752 $15,628 $15,6289 $6,888 $8,955 $11,021 $13,088 $15,154 $17,221 $17,221
10 $7,525 $9,783 $12,041 $14,298 $16,556 $18,814 $18,814
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Law
renc
e
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,700 $2,209 $2,719 $3,229 $3,739 $4,249 $4,2492 $2,304 $2,996 $3,687 $4,378 $5,070 $5,761 $5,7613 $2,909 $3,782 $4,655 $5,527 $6,400 $7,273 $7,2734 $3,514 $4,568 $5,622 $6,677 $7,731 $8,785 $8,7855 $4,119 $5,354 $6,590 $7,826 $9,061 $10,297 $10,2976 $4,724 $6,141 $7,558 $8,975 $10,392 $11,809 $11,8097 $5,328 $6,927 $8,525 $10,124 $11,722 $13,321 $13,3218 $5,933 $7,713 $9,493 $11,273 $13,053 $14,833 $14,8339 $6,538 $8,499 $10,461 $12,422 $14,384 $16,345 $16,345
10 $7,143 $9,286 $11,428 $13,571 $15,714 $17,857 $17,857
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Leba
non
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,639 $2,131 $2,622 $3,114 $3,606 $4,097 $4,0972 $2,222 $2,889 $3,555 $4,222 $4,889 $5,555 $5,5553 $2,805 $3,647 $4,488 $5,330 $6,172 $7,013 $7,0134 $3,389 $4,405 $5,422 $6,438 $7,455 $8,471 $8,4715 $3,972 $5,163 $6,355 $7,546 $8,738 $9,929 $9,9296 $4,555 $5,921 $7,288 $8,654 $10,021 $11,387 $11,3877 $5,138 $6,680 $8,221 $9,762 $11,304 $12,845 $12,8458 $5,721 $7,438 $9,154 $10,870 $12,587 $14,303 $14,3039 $6,305 $8,196 $10,087 $11,979 $13,870 $15,761 $15,761
10 $6,888 $8,954 $11,020 $13,087 $15,153 $17,219 $17,219
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Lehi
gh
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,942 $2,525 $3,108 $3,691 $4,273 $4,856 $4,8562 $2,634 $3,424 $4,214 $5,004 $5,794 $6,584 $6,5843 $3,325 $4,322 $5,320 $6,317 $7,315 $8,312 $8,3124 $4,016 $5,221 $6,426 $7,630 $8,835 $10,040 $10,0405 $4,707 $6,119 $7,532 $8,944 $10,356 $11,768 $11,7686 $5,398 $7,018 $8,637 $10,257 $11,876 $13,496 $13,4967 $6,090 $7,916 $9,743 $11,570 $13,397 $15,224 $15,2248 $6,781 $8,815 $10,849 $12,884 $14,918 $16,952 $16,9529 $7,472 $9,714 $11,955 $14,197 $16,438 $18,680 $18,680
10 $8,163 $10,612 $13,061 $15,510 $17,959 $20,408 $20,408
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Luze
rne
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,679 $2,183 $2,687 $3,191 $3,695 $4,198 $4,1982 $2,277 $2,960 $3,643 $4,326 $5,009 $5,692 $5,6923 $2,875 $3,737 $4,599 $5,462 $6,324 $7,186 $7,1864 $3,472 $4,514 $5,555 $6,597 $7,639 $8,680 $8,6805 $4,070 $5,291 $6,512 $7,733 $8,953 $10,174 $10,1746 $4,667 $6,068 $7,468 $8,868 $10,268 $11,668 $11,6687 $5,265 $6,844 $8,424 $10,003 $11,583 $13,162 $13,1628 $5,863 $7,621 $9,380 $11,139 $12,898 $14,656 $14,6569 $6,460 $8,398 $10,336 $12,274 $14,212 $16,150 $16,150
10 $7,058 $9,175 $11,292 $13,410 $15,527 $17,644 $17,644
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Lyco
min
g
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,609 $2,091 $2,574 $3,056 $3,539 $4,021 $4,0212 $2,181 $2,835 $3,490 $4,144 $4,798 $5,452 $5,4523 $2,753 $3,579 $4,405 $5,231 $6,057 $6,883 $6,8834 $3,326 $4,323 $5,321 $6,319 $7,317 $8,314 $8,3145 $3,898 $5,068 $6,237 $7,406 $8,576 $9,745 $9,7456 $4,471 $5,812 $7,153 $8,494 $9,835 $11,176 $11,1767 $5,043 $6,556 $8,069 $9,582 $11,094 $12,607 $12,6078 $5,615 $7,300 $8,985 $10,669 $12,354 $14,038 $14,0389 $6,188 $8,044 $9,900 $11,757 $13,613 $15,469 $15,469
10 $6,760 $8,788 $10,816 $12,844 $14,872 $16,900 $16,900
Client Liability: 0% 10% 20% 30% 40% 50% 100%
McK
ean
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,629 $2,117 $2,606 $3,095 $3,583 $4,072 $4,0722 $2,208 $2,871 $3,533 $4,196 $4,858 $5,521 $5,5213 $2,788 $3,624 $4,461 $5,297 $6,134 $6,970 $6,9704 $3,368 $4,378 $5,388 $6,398 $7,409 $8,419 $8,4195 $3,947 $5,131 $6,315 $7,500 $8,684 $9,868 $9,8686 $4,527 $5,885 $7,243 $8,601 $9,959 $11,317 $11,3177 $5,106 $6,638 $8,170 $9,702 $11,234 $12,766 $12,7668 $5,686 $7,392 $9,098 $10,803 $12,509 $14,215 $14,2159 $6,266 $8,145 $10,025 $11,905 $13,784 $15,664 $15,664
10 $6,845 $8,899 $10,952 $13,006 $15,059 $17,113 $17,113
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Mer
cer
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,609 $2,091 $2,574 $3,056 $3,539 $4,021 $4,0212 $2,181 $2,835 $3,490 $4,144 $4,798 $5,452 $5,4523 $2,753 $3,579 $4,405 $5,231 $6,057 $6,883 $6,8834 $3,326 $4,323 $5,321 $6,319 $7,317 $8,314 $8,3145 $3,898 $5,068 $6,237 $7,406 $8,576 $9,745 $9,7456 $4,471 $5,812 $7,153 $8,494 $9,835 $11,176 $11,1767 $5,043 $6,556 $8,069 $9,582 $11,094 $12,607 $12,6078 $5,615 $7,300 $8,985 $10,669 $12,354 $14,038 $14,0389 $6,188 $8,044 $9,900 $11,757 $13,613 $15,469 $15,469
10 $6,760 $8,788 $10,816 $12,844 $14,872 $16,900 $16,900
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Miff
lin
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,538 $1,999 $2,460 $2,922 $3,383 $3,844 $3,8442 $2,085 $2,710 $3,336 $3,961 $4,587 $5,212 $5,2123 $2,632 $3,422 $4,211 $5,001 $5,791 $6,580 $6,5804 $3,179 $4,133 $5,087 $6,041 $6,995 $7,948 $7,9485 $3,727 $4,844 $5,962 $7,080 $8,198 $9,316 $9,3166 $4,274 $5,556 $6,838 $8,120 $9,402 $10,684 $10,6847 $4,821 $6,267 $7,713 $9,160 $10,606 $12,052 $12,0528 $5,368 $6,979 $8,589 $10,199 $11,810 $13,420 $13,4209 $5,915 $7,690 $9,465 $11,239 $13,014 $14,788 $14,788
10 $6,463 $8,401 $10,340 $12,279 $14,218 $16,156 $16,156
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Mon
roe
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $2,003 $2,604 $3,205 $3,806 $4,407 $5,008 $5,0082 $2,716 $3,531 $4,345 $5,160 $5,975 $6,790 $6,7903 $3,429 $4,457 $5,486 $6,515 $7,543 $8,572 $8,5724 $4,142 $5,384 $6,626 $7,869 $9,111 $10,354 $10,3545 $4,854 $6,311 $7,767 $9,223 $10,679 $12,136 $12,1366 $5,567 $7,237 $8,907 $10,577 $12,248 $13,918 $13,9187 $6,280 $8,164 $10,048 $11,932 $13,816 $15,700 $15,7008 $6,993 $9,091 $11,188 $13,286 $15,384 $17,482 $17,4829 $7,706 $10,017 $12,329 $14,640 $16,952 $19,264 $19,264
10 $8,418 $10,944 $13,469 $15,995 $18,520 $21,046 $21,046
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Mon
tgom
ery
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $2,590 $3,367 $4,144 $4,921 $5,698 $6,475 $6,4752 $3,511 $4,565 $5,618 $6,672 $7,725 $8,779 $8,7793 $4,433 $5,763 $7,093 $8,423 $9,753 $11,083 $11,0834 $5,355 $6,961 $8,567 $10,174 $11,780 $13,387 $13,3875 $6,276 $8,159 $10,042 $11,925 $13,808 $15,691 $15,6916 $7,198 $9,357 $11,517 $13,676 $15,835 $17,995 $17,9957 $8,119 $10,555 $12,991 $15,427 $17,863 $20,299 $20,2998 $9,041 $11,753 $14,466 $17,178 $19,890 $22,603 $22,6039 $9,963 $12,951 $15,940 $18,929 $21,918 $24,907 $24,907
10 $10,884 $14,150 $17,415 $20,680 $23,945 $27,211 $27,211
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Mon
tour
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,740 $2,262 $2,784 $3,306 $3,828 $4,350 $4,3502 $2,359 $3,067 $3,775 $4,483 $5,190 $5,898 $5,8983 $2,978 $3,872 $4,766 $5,659 $6,553 $7,446 $7,4464 $3,598 $4,677 $5,756 $6,836 $7,915 $8,994 $8,9945 $4,217 $5,482 $6,747 $8,012 $9,277 $10,542 $10,5426 $4,836 $6,287 $7,738 $9,189 $10,639 $12,090 $12,0907 $5,455 $7,092 $8,728 $10,365 $12,002 $13,638 $13,6388 $6,074 $7,897 $9,719 $11,541 $13,364 $15,186 $15,1869 $6,694 $8,702 $10,710 $12,718 $14,726 $16,734 $16,734
10 $7,313 $9,507 $11,701 $13,894 $16,088 $18,282 $18,282
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Nor
tham
pton
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,983 $2,578 $3,173 $3,767 $4,362 $4,957 $4,9572 $2,688 $3,495 $4,302 $5,108 $5,915 $6,721 $6,7213 $3,394 $4,412 $5,431 $6,449 $7,467 $8,485 $8,4854 $4,100 $5,330 $6,559 $7,789 $9,019 $10,249 $10,2495 $4,805 $6,247 $7,688 $9,130 $10,572 $12,013 $12,0136 $5,511 $7,164 $8,817 $10,471 $12,124 $13,777 $13,7777 $6,216 $8,081 $9,946 $11,811 $13,676 $15,541 $15,5418 $6,922 $8,999 $11,075 $13,152 $15,229 $17,305 $17,3059 $7,628 $9,916 $12,204 $14,493 $16,781 $19,069 $19,069
10 $8,333 $10,833 $13,333 $15,833 $18,333 $20,833 $20,833
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Nor
thum
berla
nd
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,609 $2,091 $2,574 $3,056 $3,539 $4,021 $4,0212 $2,181 $2,835 $3,490 $4,144 $4,798 $5,452 $5,4523 $2,753 $3,579 $4,405 $5,231 $6,057 $6,883 $6,8834 $3,326 $4,323 $5,321 $6,319 $7,317 $8,314 $8,3145 $3,898 $5,068 $6,237 $7,406 $8,576 $9,745 $9,7456 $4,471 $5,812 $7,153 $8,494 $9,835 $11,176 $11,1767 $5,043 $6,556 $8,069 $9,582 $11,094 $12,607 $12,6078 $5,615 $7,300 $8,985 $10,669 $12,354 $14,038 $14,0389 $6,188 $8,044 $9,900 $11,757 $13,613 $15,469 $15,469
10 $6,760 $8,788 $10,816 $12,844 $14,872 $16,900 $16,900
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Perr
y
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,619 $2,104 $2,590 $3,075 $3,561 $4,047 $4,0472 $2,195 $2,853 $3,511 $4,170 $4,828 $5,487 $5,4873 $2,771 $3,602 $4,433 $5,264 $6,095 $6,927 $6,9274 $3,347 $4,351 $5,355 $6,359 $7,363 $8,367 $8,3675 $3,923 $5,099 $6,276 $7,453 $8,630 $9,807 $9,8076 $4,499 $5,848 $7,198 $8,547 $9,897 $11,247 $11,2477 $5,075 $6,597 $8,119 $9,642 $11,164 $12,687 $12,6878 $5,651 $7,346 $9,041 $10,736 $12,431 $14,127 $14,1279 $6,227 $8,095 $9,963 $11,831 $13,699 $15,567 $15,567
10 $6,803 $8,843 $10,884 $12,925 $14,966 $17,007 $17,007
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Phila
delp
hia
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $2,003 $2,604 $3,205 $3,806 $4,407 $5,008 $5,0082 $2,716 $3,531 $4,345 $5,160 $5,975 $6,790 $6,7903 $3,429 $4,457 $5,486 $6,515 $7,543 $8,572 $8,5724 $4,142 $5,384 $6,626 $7,869 $9,111 $10,354 $10,3545 $4,854 $6,311 $7,767 $9,223 $10,679 $12,136 $12,1366 $5,567 $7,237 $8,907 $10,577 $12,248 $13,918 $13,9187 $6,280 $8,164 $10,048 $11,932 $13,816 $15,700 $15,7008 $6,993 $9,091 $11,188 $13,286 $15,384 $17,482 $17,4829 $7,706 $10,017 $12,329 $14,640 $16,952 $19,264 $19,264
10 $8,418 $10,944 $13,469 $15,995 $18,520 $21,046 $21,046
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Pike
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $2,226 $2,893 $3,561 $4,229 $4,896 $5,564 $5,5642 $3,018 $3,923 $4,828 $5,734 $6,639 $7,544 $7,5443 $3,810 $4,953 $6,095 $7,238 $8,381 $9,524 $9,5244 $4,602 $5,982 $7,363 $8,743 $10,124 $11,504 $11,5045 $5,394 $7,012 $8,630 $10,248 $11,866 $13,484 $13,4846 $6,186 $8,041 $9,897 $11,753 $13,608 $15,464 $15,4647 $6,978 $9,071 $11,164 $13,258 $15,351 $17,444 $17,4448 $7,770 $10,101 $12,431 $14,762 $17,093 $19,424 $19,4249 $8,562 $11,130 $13,699 $16,267 $18,836 $21,404 $21,404
10 $9,354 $12,160 $14,966 $17,772 $20,578 $23,384 $23,384
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Potte
r
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,629 $2,117 $2,606 $3,095 $3,583 $4,072 $4,0722 $2,208 $2,871 $3,533 $4,196 $4,858 $5,521 $5,5213 $2,788 $3,624 $4,461 $5,297 $6,134 $6,970 $6,9704 $3,368 $4,378 $5,388 $6,398 $7,409 $8,419 $8,4195 $3,947 $5,131 $6,315 $7,500 $8,684 $9,868 $9,8686 $4,527 $5,885 $7,243 $8,601 $9,959 $11,317 $11,3177 $5,106 $6,638 $8,170 $9,702 $11,234 $12,766 $12,7668 $5,686 $7,392 $9,098 $10,803 $12,509 $14,215 $14,2159 $6,266 $8,145 $10,025 $11,905 $13,784 $15,664 $15,664
10 $6,845 $8,899 $10,952 $13,006 $15,059 $17,113 $17,113
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Schu
ylki
ll
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,598 $2,078 $2,557 $3,037 $3,517 $3,996 $3,9962 $2,167 $2,817 $3,468 $4,118 $4,768 $5,418 $5,4183 $2,736 $3,557 $4,378 $5,198 $6,019 $6,840 $6,8404 $3,305 $4,296 $5,288 $6,279 $7,271 $8,262 $8,2625 $3,874 $5,036 $6,198 $7,360 $8,522 $9,684 $9,6846 $4,442 $5,775 $7,108 $8,441 $9,773 $11,106 $11,1067 $5,011 $6,515 $8,018 $9,521 $11,025 $12,528 $12,5288 $5,580 $7,254 $8,928 $10,602 $12,276 $13,950 $13,9509 $6,149 $7,993 $9,838 $11,683 $13,527 $15,372 $15,372
10 $6,718 $8,733 $10,748 $12,764 $14,779 $16,794 $16,794
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Snyd
er
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,639 $2,131 $2,622 $3,114 $3,606 $4,097 $4,0972 $2,222 $2,889 $3,555 $4,222 $4,889 $5,555 $5,5553 $2,805 $3,647 $4,488 $5,330 $6,172 $7,013 $7,0134 $3,389 $4,405 $5,422 $6,438 $7,455 $8,471 $8,4715 $3,972 $5,163 $6,355 $7,546 $8,738 $9,929 $9,9296 $4,555 $5,921 $7,288 $8,654 $10,021 $11,387 $11,3877 $5,138 $6,680 $8,221 $9,762 $11,304 $12,845 $12,8458 $5,721 $7,438 $9,154 $10,870 $12,587 $14,303 $14,3039 $6,305 $8,196 $10,087 $11,979 $13,870 $15,761 $15,761
10 $6,888 $8,954 $11,020 $13,087 $15,153 $17,219 $17,219
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Som
erse
t
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,558 $2,025 $2,493 $2,960 $3,428 $3,895 $3,8952 $2,112 $2,746 $3,380 $4,013 $4,647 $5,281 $5,2813 $2,667 $3,467 $4,267 $5,067 $5,867 $6,667 $6,6674 $3,221 $4,188 $5,154 $6,120 $7,087 $8,053 $8,0535 $3,776 $4,908 $6,041 $7,174 $8,306 $9,439 $9,4396 $4,330 $5,629 $6,928 $8,227 $9,526 $10,825 $10,8257 $4,884 $6,350 $7,815 $9,280 $10,746 $12,211 $12,2118 $5,439 $7,070 $8,702 $10,334 $11,965 $13,597 $13,5979 $5,993 $7,791 $9,589 $11,387 $13,185 $14,983 $14,983
10 $6,548 $8,512 $10,476 $12,440 $14,405 $16,369 $16,369
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Sulli
van
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,598 $2,078 $2,557 $3,037 $3,517 $3,996 $3,9962 $2,167 $2,817 $3,468 $4,118 $4,768 $5,418 $5,4183 $2,736 $3,557 $4,378 $5,198 $6,019 $6,840 $6,8404 $3,305 $4,296 $5,288 $6,279 $7,271 $8,262 $8,2625 $3,874 $5,036 $6,198 $7,360 $8,522 $9,684 $9,6846 $4,442 $5,775 $7,108 $8,441 $9,773 $11,106 $11,1067 $5,011 $6,515 $8,018 $9,521 $11,025 $12,528 $12,5288 $5,580 $7,254 $8,928 $10,602 $12,276 $13,950 $13,9509 $6,149 $7,993 $9,838 $11,683 $13,527 $15,372 $15,372
10 $6,718 $8,733 $10,748 $12,764 $14,779 $16,794 $16,794
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Susq
ueha
nna
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,619 $2,104 $2,590 $3,075 $3,561 $4,047 $4,0472 $2,195 $2,853 $3,511 $4,170 $4,828 $5,487 $5,4873 $2,771 $3,602 $4,433 $5,264 $6,095 $6,927 $6,9274 $3,347 $4,351 $5,355 $6,359 $7,363 $8,367 $8,3675 $3,923 $5,099 $6,276 $7,453 $8,630 $9,807 $9,8076 $4,499 $5,848 $7,198 $8,547 $9,897 $11,247 $11,2477 $5,075 $6,597 $8,119 $9,642 $11,164 $12,687 $12,6878 $5,651 $7,346 $9,041 $10,736 $12,431 $14,127 $14,1279 $6,227 $8,095 $9,963 $11,831 $13,699 $15,567 $15,567
10 $6,803 $8,843 $10,884 $12,925 $14,966 $17,007 $17,007
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Tiog
a
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,679 $2,183 $2,687 $3,191 $3,695 $4,198 $4,1982 $2,277 $2,960 $3,643 $4,326 $5,009 $5,692 $5,6923 $2,875 $3,737 $4,599 $5,462 $6,324 $7,186 $7,1864 $3,472 $4,514 $5,555 $6,597 $7,639 $8,680 $8,6805 $4,070 $5,291 $6,512 $7,733 $8,953 $10,174 $10,1746 $4,667 $6,068 $7,468 $8,868 $10,268 $11,668 $11,6687 $5,265 $6,844 $8,424 $10,003 $11,583 $13,162 $13,1628 $5,863 $7,621 $9,380 $11,139 $12,898 $14,656 $14,6569 $6,460 $8,398 $10,336 $12,274 $14,212 $16,150 $16,150
10 $7,058 $9,175 $11,292 $13,410 $15,527 $17,644 $17,644
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Uni
on
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,730 $2,249 $2,768 $3,287 $3,806 $4,325 $4,3252 $2,346 $3,049 $3,753 $4,457 $5,160 $5,864 $5,8643 $2,961 $3,849 $4,738 $5,626 $6,515 $7,403 $7,4034 $3,577 $4,650 $5,723 $6,796 $7,869 $8,942 $8,9425 $4,192 $5,450 $6,708 $7,965 $9,223 $10,481 $10,4816 $4,808 $6,250 $7,693 $9,135 $10,577 $12,020 $12,0207 $5,424 $7,051 $8,678 $10,305 $11,932 $13,559 $13,5598 $6,039 $7,851 $9,663 $11,474 $13,286 $15,098 $15,0989 $6,655 $8,651 $10,648 $12,644 $14,640 $16,637 $16,637
10 $7,270 $9,451 $11,633 $13,814 $15,995 $18,176 $18,176
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Vena
ngo
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,588 $2,065 $2,541 $3,018 $3,494 $3,971 $3,9712 $2,154 $2,800 $3,446 $4,092 $4,738 $5,384 $5,3843 $2,719 $3,534 $4,350 $5,166 $5,981 $6,797 $6,7974 $3,284 $4,269 $5,254 $6,239 $7,225 $8,210 $8,2105 $3,849 $5,004 $6,159 $7,313 $8,468 $9,623 $9,6236 $4,414 $5,739 $7,063 $8,387 $9,711 $11,036 $11,0367 $4,980 $6,473 $7,967 $9,461 $10,955 $12,449 $12,4498 $5,545 $7,208 $8,872 $10,535 $12,198 $13,862 $13,8629 $6,110 $7,943 $9,776 $11,609 $13,442 $15,275 $15,275
10 $6,675 $8,678 $10,680 $12,683 $14,685 $16,688 $16,688
Client Liability: 0% 10% 20% 30% 40% 50% 100%
War
ren
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,609 $2,091 $2,574 $3,056 $3,539 $4,021 $4,0212 $2,181 $2,835 $3,490 $4,144 $4,798 $5,452 $5,4523 $2,753 $3,579 $4,405 $5,231 $6,057 $6,883 $6,8834 $3,326 $4,323 $5,321 $6,319 $7,317 $8,314 $8,3145 $3,898 $5,068 $6,237 $7,406 $8,576 $9,745 $9,7456 $4,471 $5,812 $7,153 $8,494 $9,835 $11,176 $11,1767 $5,043 $6,556 $8,069 $9,582 $11,094 $12,607 $12,6078 $5,615 $7,300 $8,985 $10,669 $12,354 $14,038 $14,0389 $6,188 $8,044 $9,900 $11,757 $13,613 $15,469 $15,469
10 $6,760 $8,788 $10,816 $12,844 $14,872 $16,900 $16,900
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Was
hing
ton
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,639 $2,131 $2,622 $3,114 $3,606 $4,097 $4,0972 $2,222 $2,889 $3,555 $4,222 $4,889 $5,555 $5,5553 $2,805 $3,647 $4,488 $5,330 $6,172 $7,013 $7,0134 $3,389 $4,405 $5,422 $6,438 $7,455 $8,471 $8,4715 $3,972 $5,163 $6,355 $7,546 $8,738 $9,929 $9,9296 $4,555 $5,921 $7,288 $8,654 $10,021 $11,387 $11,3877 $5,138 $6,680 $8,221 $9,762 $11,304 $12,845 $12,8458 $5,721 $7,438 $9,154 $10,870 $12,587 $14,303 $14,3039 $6,305 $8,196 $10,087 $11,979 $13,870 $15,761 $15,761
10 $6,888 $8,954 $11,020 $13,087 $15,153 $17,219 $17,219
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Way
ne
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,689 $2,196 $2,703 $3,210 $3,717 $4,224 $4,2242 $2,291 $2,978 $3,665 $4,352 $5,040 $5,727 $5,7273 $2,892 $3,759 $4,627 $5,495 $6,362 $7,230 $7,2304 $3,493 $4,541 $5,589 $6,637 $7,685 $8,733 $8,7335 $4,094 $5,323 $6,551 $7,779 $9,007 $10,236 $10,2366 $4,695 $6,104 $7,513 $8,921 $10,330 $11,739 $11,7397 $5,297 $6,886 $8,475 $10,064 $11,653 $13,242 $13,2428 $5,898 $7,667 $9,437 $11,206 $12,975 $14,745 $14,7459 $6,499 $8,449 $10,399 $12,348 $14,298 $16,248 $16,248
10 $7,100 $9,230 $11,360 $13,491 $15,621 $17,751 $17,751
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Wes
tmor
elan
d
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,669 $2,170 $2,671 $3,172 $3,672 $4,173 $4,1732 $2,263 $2,942 $3,621 $4,300 $4,979 $5,658 $5,6583 $2,857 $3,714 $4,572 $5,429 $6,286 $7,143 $7,1434 $3,451 $4,487 $5,522 $6,557 $7,593 $8,628 $8,6285 $4,045 $5,259 $6,472 $7,686 $8,900 $10,113 $10,1136 $4,639 $6,031 $7,423 $8,815 $10,206 $11,598 $11,5987 $5,233 $6,803 $8,373 $9,943 $11,513 $13,083 $13,0838 $5,827 $7,575 $9,324 $11,072 $12,820 $14,568 $14,5689 $6,421 $8,348 $10,274 $12,200 $14,127 $16,053 $16,053
10 $7,015 $9,120 $11,224 $13,329 $15,434 $17,538 $17,538
Client Liability: 0% 10% 20% 30% 40% 50% 100%
Wyo
min
g
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,679 $2,183 $2,687 $3,191 $3,695 $4,198 $4,1982 $2,277 $2,960 $3,643 $4,326 $5,009 $5,692 $5,6923 $2,875 $3,737 $4,599 $5,462 $6,324 $7,186 $7,1864 $3,472 $4,514 $5,555 $6,597 $7,639 $8,680 $8,6805 $4,070 $5,291 $6,512 $7,733 $8,953 $10,174 $10,1746 $4,667 $6,068 $7,468 $8,868 $10,268 $11,668 $11,6687 $5,265 $6,844 $8,424 $10,003 $11,583 $13,162 $13,1628 $5,863 $7,621 $9,380 $11,139 $12,898 $14,656 $14,6569 $6,460 $8,398 $10,336 $12,274 $14,212 $16,150 $16,150
10 $7,058 $9,175 $11,292 $13,410 $15,527 $17,644 $17,644
Client Liability: 0% 10% 20% 30% 40% 50% 100%
York
Intensive Outpatient/Partial Hospitalization
Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income Monthly Income MonthlyEqual to or Equal to or Equal to or Equal to or Equal to or Equal to or Income
Family Size Less Than Less Than Less Than Less Than Less Than Less Than Greater Than
1 $1,689 $2,196 $2,703 $3,210 $3,717 $4,224 $4,2242 $2,291 $2,978 $3,665 $4,352 $5,040 $5,727 $5,7273 $2,892 $3,759 $4,627 $5,495 $6,362 $7,230 $7,2304 $3,493 $4,541 $5,589 $6,637 $7,685 $8,733 $8,7335 $4,094 $5,323 $6,551 $7,779 $9,007 $10,236 $10,2366 $4,695 $6,104 $7,513 $8,921 $10,330 $11,739 $11,7397 $5,297 $6,886 $8,475 $10,064 $11,653 $13,242 $13,2428 $5,898 $7,667 $9,437 $11,206 $12,975 $14,745 $14,7459 $6,499 $8,449 $10,399 $12,348 $14,298 $16,248 $16,248
10 $7,100 $9,230 $11,360 $13,491 $15,621 $17,751 $17,751
Client Liability: 0% 10% 20% 30% 40% 50% 100%